Sunday, June 3, 2012

Cherry Picking...or...Metastasectomy for Metastatic Melanoma

My report on:
Metastasectomy for Distant Metastatic Melanoma: Analysis of Data from the First Multicenter Selective Lymphadenectomy Trial (MSLT_I)  From:  Ann Surg Oncology, 2012, May 31 [Epub] Howard, Thompson, Mozzillo, et al

Basically, my first oncologist called it "cherry picking"... the removal of melanoma lesions as they appeared with sentinel node biopsy, wide excision, and lymphadenectomy.  (In other words, cutting out the problem, along with a good deal of tissue around it, checking the lymph nodes to which the area drained, and removing the nodes in that area.  Obvious problem is that not everything in your body is removable!!!)  And, as she told it, many patients did rather well.  She was not wrong.

According to these peeps, most stage IV melanoma patients are treated with systemic medical therapy and surgery is simply adjunctive.  But, as they looked at the data...which is rather long and arduous...the final outcome suggested that over half of the stage IV melanoma patients they looked at were "candidates for resection and exhibit improved survival over patients receiving systemic medical therapy alone, regardless of site and number of metastases."

So...according to this data....get it outa there!  Easier said than done at times though, huh???  - c

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