ASO Author Reflections: What Role Do Surgeons Play in the Era of Effective Systemic Therapy for Melanoma?

Excerpt

Before the introduction of effective systemic therapy, metastasectomy was considered an important therapeutic option for carefully selected patients with stage 4 melanoma. Whereas historically, systemic options were associated with low response rates and median survivals measured in months, complete resection could achieve 5-year overall survival rates of up to 40%.1 Development of immune checkpoint inhibitors and molecularly targeted agents has altered the therapeutic landscape, necessitating reexamination of the role played by metastasectomy in stage 4 melanoma.2 How has the availability of these drugs changed selection for surgery? Does metastasectomy still appear to contribute to improved outcomes? Should it come before systemic therapy or afterward? …