{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:50:14Z","timestamp":1789062614942,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,6,3]],"date-time":"2019-06-03T00:00:00Z","timestamp":1559520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>Current literature supports mixed conclusions regarding the outcomes of metastasectomy in Stage <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> melanoma. The objective of this national study was to determine the associations of non\u2010primary site surgery with overall survival (<jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>) in Stage <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> melanoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The National Cancer Database (<jats:styled-content style=\"fixed-case\">NCDB<\/jats:styled-content>) was queried for all Stage <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> melanoma cases diagnosed from 2004 to 2015. Cases missing treatment\/staging data or undergoing palliative treatment were excluded (remaining <jats:italic>n<\/jats:italic>\u00a0=\u00a014\u00a0034). Patients were separated into \u2018metastasectomy\u2019 (<jats:italic>n<\/jats:italic>\u00a0=\u00a04214, 30.0%) and \u2018non\u2010metastasectomy\u2019 (<jats:italic>n<\/jats:italic>\u00a0=\u00a09820, 70.0%) cohorts. Survival outcomes were analysed using Kaplan\u2013Meier and Cox proportional hazards regressions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On univariate analysis, patients with Stage <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> melanoma undergoing metastasectomy (median survival: 15.67\u00a0month) had greater overall survival compared with those not receiving non\u2010primary surgery (median survival: 7.13\u00a0month; 5\u2010year <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> 13.2% vs. 5.6%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). M1a patients that underwent non\u2010primary metastasectomy (median survival: 46.36\u00a0month) showed greater survival than those that did not (median survival: 15.31 month; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Metastasectomy was undertaken more frequently for cutaneous (M1a) metastasis compared with non\u2010M1a metastasis (34.6% vs. 28.4%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Of those receiving metastasectomy, 20.3% also received primary site resection, 33.6% radiation, 26.5% chemotherapy and 31.5% immunotherapy. Controlling for covariates on Cox proportional hazard analysis, all metastasectomy patients demonstrated longer survival [Hazard Ratio\u00a0=\u00a00.519, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001; <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 95% (0.495\u20130.545)] as well as when analysing solely M1a metastasectomy patients [Hazard Ratio\u00a0=\u00a00.546, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001; <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 95% (0.456\u20130.653)], lung (M1b) metastasectomy patients [Hazard Ratio\u00a0=\u00a00.389, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001; <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 95% (0.328\u20130.462)] and visceral (M1c) metastasectomy patients [Hazard Ratio\u00a0=\u00a00.474, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001; <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 95% (0.434\u20130.517)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Metastasectomy for Stage <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> melanoma is independently associated with improved <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> in metastatic cases involving the skin, lung and visceral organs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.15667","type":"journal-article","created":{"date-parts":[[2019,5,9]],"date-time":"2019-05-09T17:33:51Z","timestamp":1557423231000},"page":"1719-1725","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Prolonged overall survival following metastasectomy in stage <scp>IV<\/scp> melanoma"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3281-1660","authenticated-orcid":false,"given":"M.L.","family":"Elias","sequence":"first","affiliation":[{"name":"Rutgers New Jersey Medical 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