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Prognosis of Patients With Stage III Melanoma According to AJCCv8 vs Independent Cohorts


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In a study reported in the Journal of Clinical Oncology, Garbe et al found that melanoma-specific survival rates for patients with stage III disease differed markedly in three independent cohorts compared with those reported in American Joint Committee on Cancer version 8 (AJCCv8) stage III survival data.

Study Details

In the analysis, melanoma-specific survival rates for stage III disease from 1,553 patients in the German Central Malignant Melanoma Registry (CMMR), 573 patients from the observation arm of the European Organisation for Research and Treatment of Cancer (EORTC) 18991 study, and 445 patients in the placebo arm of the EORTC 18071 study were compared with rates reported in the International Melanoma Database and Discovery Platform (IMDDP) analysis presented in the AJCCv8 classification.

Key Findings

For all patients with stage III disease in the IMDDP analysis, 5- and 10-year melanoma-specific survival was 77.0% and 69.0%. In comparison, 5- and 10-year rates were 67.0% and 55.6% for the CMMR cohort, and 5-year rates (10-year rates not available) were 52.7% for the EORTC 18991 cohort and 55.5% for the EORTC 18071 cohort.

For stage IIIA disease, 5- and 10-year rates were 93.0% and 88.0% in the IMDDP analysis. In comparison, 5- and 10-year rates were 80.0% and 55.6% for the CMMR cohort, and 5-year rates were 80.4% for the EORTC 18991 cohort and 72.5% for the EORTC 18071 cohort.

For stage IIIB disease, 5- and 10-year rates were 83.0% and 77.0% in the IMDDP analysis. In comparison, 5- and 10-year rates were 74.5% and 60.6% for the CMMR cohort, and 5-year rates were 56.2% for the EORTC 18991 cohort and 65.8% for the EORTC 18071 cohort.

For stage IIIC disease, 5- and 10-year rates were 69.0% and 60.0% in the IMDDP analysis. In comparison, 5- and 10-year rates were 55.9% and 44.9% for the CMMR cohort, and 5-year rates were 41.8% for the EORTC 18991 cohort and 47.6% for the EORTC 18071 cohort.

For stage IIID disease, 5- and 10-year rates were 32.0% and 24.0% in the IMDDP analysis. In comparison, 5- and 10-year rates were 29.9% and 29.9% for the CMMR cohort, and 5-year rates were 20.0% for the EORTC 18991 cohort and 27.5% for the EORTC 18071 cohort.

The investigators concluded, “The melanoma-specific survival rates in the CMMR and EORTC cohorts over the entire stage III are less favorable than those published in AJCCv8. This is particularly true for substages IIIA and IIIB…the difference shown here should be taken into account in clinical decision making (eg, on initiation of adjuvant therapy) and in the planning of clinical trials.”

Claus Garbe, MD, of the Center for Dermatooncology, Eberhard Karls University, Tuebingen, is the corresponding author for the Journal of Clinical Oncology article.

Disclosure: The study was supported by the German Central Malignant Melanoma Registry and by the European Organisation for Research and Treatment of Cancer. For full disclosures of the study authors, visit ascopubs.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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