Complete surgical resection of residual melanoma metastasis and survival in stage IV patients following high-dose IL-2 therapy.

20000 Patients diagnosed with systemic melanoma metastasis historically have a very poor prognosis. Immunotherapy with high-dose IL-2 (HD IL-2) is associated with improved overall survival (OS) in select patients who achieve a complete response (CR) and, to a lesser extent, a partial response (PR) following treatment. In order to evaluate the role of complete surgical resection of melanoma metastasis in patients with residual disease following HD IL-2 therapy, we retrospectively reviewed our database of 145 AJCC stage IV melanoma patients (97 males/ 48 females; mean age 52 yrs) treated at our institution from January 2002 to the present. A mean of 2.2 cycles of HD IL-2 were completed by the group. There were 3 treatment related deaths. The median follow-up for all patients was 7 months. Overall response rate was 14%, with 4% CR and 10% PR. Eleven patients (8 PR, 3 stable disease) were able to attain surgical complete response (sCR) with resection of residual disease following HD IL-2. There were no post-operative complications. The mean number of disease sites resected was 1.4 and were as follows: 6 lung, 2 lymph node, 5 soft tissue, 1 bowel, and 1 bone. The median overall survival was 8 mos for the entire group, but it has not yet been reached in patients achieving sCR after a mean follow-up of 31 mos (p< 0.001). An aggressive surgical approach in metastatic melanoma patients with limited sites of disease who achieve a PR or SD following HD IL-2 therapy that results in a sCR is associated with improved overall survival. No significant financial relationships to disclose.