Experiencia clínica en el tratamiento adyuvante de los pacientes con melanoma de tronco y extremidades estado III en un hospital del Tercer Mundo

Abstract

ObjectivesTo describe the experience with the use of adjuvant high-dose interferon in patients with stage III melanoma of the trunk and extremities, establishing the causes why patients with an indication of adjuvant treatment did not receive it, as well as major toxicity and outcomes. Materials and MethodsThis is a retrospective study of a cohort of patients diagnosed with melanoma of the trunk and extremities, who were subjected to surgical treatment of the primary lesion and lymph node dissection in the INC over a ten-year period (1999-2009), and who had an indication for Interferon adjuvant treatment. ResultsA total 88 patients were diagnosed with Stage III melanoma of the trunk and extremities, of whom 50 (56.8%) were identified to have received adjuvant treatment with interferon. Among the main reasons why the remaining 38 patients did not receive it were, age and associated comorbidities (21), delayed oncology consultation (5), and decision of medical oncologist (5). Only 36% (18) patients received interferon for more than 10 months, and 62% of patients (N=31) discontinued treatment. The main reason for suspending treatment was disease progression (N=16, 51.6%), and 25 patients had grade III toxicity. A lower incidence of relapse was found in the group receiving the drug. ConclusionIn this cohort it was found that patients with stage III melanoma receiving adjuvant interferon therapy had a lower relapse rate and better disease-free survival, which is in agreement with that reported in the literature.