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Early Desmoplastic Melanoma Treatment Comparison

Melanoma Res; ePub 2018 Oct 31; Abbott, et al

There was significantly improved overall survival (OS) in patients with early-stage desmoplastic melanoma (DM) treated with wide local excision and adjuvant radiation therapy (WLE+RT) compared to WLE alone, according to a recent investigation. In this retrospective study of the National Cancer Database, 2,390 patients with localized DM were included for analysis. 2,082 were treated with WLE and 308 were treated with WLE and adjuvant radiation therapy WLE+RT. OS in these groups was compared on crude and adjusted analyses utilizing Cox proportional hazards regression modeling. Researchers found:

  • There was no difference in OS at 1, 3, and 5 years on initial analysis.
  • Subsequent multivariate analysis and propensity score analysis showed a survival benefit in those treated with WLE+RT.
  • Multivariate analysis demonstrated significantly decreased OS in cases of residual tumor following surgical excision.
  • Adjuvant radiation was more likely to be performed for tumors on the head and neck, tumors with higher pathologic American Joint Committee on cancer stage and T classifications, and tumors with positive surgical margins.

Abbott JL, Qureshi MM, Truong MT, Sahni D. Comparing survival outcomes in early stage desmoplastic melanoma with or without adjuvant radiation. [Published online ahead of print October 31, 2018]. Melanoma Res. doi:10.1097/CMR.0000000000000532.