Sorting Through the Heterogeneity of Recurrent Melanoma

Excerpt

A critical component of managing oncology patients is understanding the natural history of their cancer and identifying those features of the tumor and the patient that predict the metastatic process and survival outcome. The clinical behavior of recurrent or metastatic melanoma is remarkably heterogeneous. In this issue of the Annals of Surgical Oncology, Francken, Thompson and colleagues from the Sydney Melanoma Unit have made yet another valuable contribution to the literature with their assessment of survival outcomes, and independent predictors of survival outcomes in patients with recurrent melanoma.1 Most studies of prognostic factors in melanoma patients have examined outcomes from the time of the original diagnosis.2,3 This study analyzes prognostic factors predicting metastatic behavior and survival outcome starting with the time of first relapse at different anatomic sites. The ability to predict prognosis from the time of relapse is of critical importance. Better understanding of expected prognosis in patients with recurrent melanoma allows the clinician to make better choices in disease evaluation and treatment, and most importantly for the future of melanoma care, an ability to categorize patients with recurrent disease into groups with more homogeneous prognoses will lead to better design of clinical trials of systemic therapies, hopefully hastening the time when we will have more effective therapies for our patients with advanced disease. …