Evidence map›Paper›PMID 34347220›Full record

ArticleAnnals of surgical oncology2021

Survival Outcomes of Salvage Metastasectomy After Failure of Modern-Era Systemic Therapy for Melanoma.

Andrew T Li, Kavita Vakharia, Serigne N Lo, Alexander H R Varey, Matteo S Carlino, Robyn P M Saw, Kerwin F Shannon, Julie R Howle, Thomas E Pennington, Jonathan R Stretch and 7 more

Abstract read
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In one paragraph

Article in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
0.8field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 6 institutions in 1 country.

Andrew T LiMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Kavita VakhariaMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Serigne N LoMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Alexander H R VareyMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Matteo S CarlinoMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Robyn P M SawMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Kerwin F ShannonMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Julie R HowleMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Thomas E PenningtonMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Jonathan R StretchMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Omgo E NiewegMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Andrew J SpillaneMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Georgina V LongMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Alexander M MenziesMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Richard A ScolyerMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
John F ThompsonMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Sydney Ch'ngMelanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia. sydney.chng@sydney.edu.au.
The University of Sydney · AUMelanoma Institute Australia · AURoyal Prince Alfred Hospital · AUMater Health Services · AURoyal North Shore Hospital · AUWestmead Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetastasectomy for selected patients with melanoma was associated with improved survival in the era before effective systemic therapy. Emerging evidence shows that these benefits persist even in this era of BRAF-targeted therapy and immune checkpoint inhibitor immunotherapy. This study aimed to evaluate the outcomes of salvage metastasectomy after failure of systemic therapy.

methodsStage 3 or 4 melanoma patients with extracranial disease progression after at least 4 weeks of systemic treatment between 2009 and 2020 were identified and categorized as resected to no evidence of disease (NED), non-progressive residual disease (NPRD), or progressive residual disease (PRD). Systemic therapy was stratified into BRAF-targeted therapy, immune checkpoint inhibitor immunotherapy, or both. The end points of overall survival (OS), progression-free survival (PFS), and locoregional disease control (LRC) were assessed using Kaplan-Meier curves. Uni- and multivariable Cox regression procedures were used to examine factors associated with OS, PFS and LRC.

resultsThe study enrolled 190 patients. Among all the patients, the 5-year OS from metastatectomy was 52%, the 3-year PFS was 21%, and the 5-year LRC was 61%. After resection to NED, NPRD, and PRD, the 5-year OS values were 69%, 62% and 8%, respectively. Fewer lines of preoperative therapy, use of preoperative immunotherapy, and resection to NED were predictors of improved OS. After resection to NED, NPRD, and PRD, the 3-year PFS values were 23%, 24% and 10%, and the 5-year LRC values were 61%, 72% and 34%, respectively.

conclusionsSalvage metastasectomy was associated with durable survival and disease control, particularly after resection to NED, preoperative immunotherapy, and fewer lines of preoperative systemic therapy.

Indexed as

MelanomaMetastasectomyHumansImmunotherapyNeoplasm StagingRetrospective StudiesSalvage Therapy

Identifiers

PMID34347220
OpenAlexW3191841978

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.