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. 2020 Aug 1;38(22):2543-2551.
doi: 10.1200/JCO.19.03034. Epub 2020 Jun 12.

Prognosis of Patients With Stage III Melanoma According to American Joint Committee on Cancer Version 8: A Reassessment on the Basis of 3 Independent Stage III Melanoma Cohorts

Claus Garbe  1 , Ulrike Keim  1 , Stefan Suciu  2 , Teresa Amaral  1 , Thomas K Eigentler  1 , Anja Gesierich  3 , Axel Hauschild  4 , Lucie Heinzerling  5 , Felix Kiecker  6 , Dirk Schadendorf  7 , Rudolf Stadler  8 , Cord Sunderkötter  9 , Thomas Tüting  10 , Jochen Utikal  11 , Uwe Wollina  12 , Christos C Zouboulis  13 , Ulrich Keilholz  14 , Alessandro Testori  15 , Peter Martus  16 , Ulrike Leiter  1 , Alexander M M Eggermont  17 ; German Central Malignant Melanoma Registry and the European Organisation for Research and Treatment of Cancer
Affiliations

Prognosis of Patients With Stage III Melanoma According to American Joint Committee on Cancer Version 8: A Reassessment on the Basis of 3 Independent Stage III Melanoma Cohorts

Claus Garbe et al. J Clin Oncol. .

Abstract

Purpose: Three new therapies have been approved recently for the adjuvant treatment of stage III melanoma, substantially reducing the risk of tumor recurrences. This study evaluates 3 independent data sets to clarify the survival probabilities of patients with stage III melanoma.

Patients and methods: The Central Malignant Melanoma Registry (CMMR) evaluated 1,553 patients with a primary diagnosis of stage III melanoma from 2000 to 2012. Studies from the European Organisation for Research and Treatment of Cancer (EORTC), of 573 patients in the observation arm of the 18991 study and 445 patients in the placebo arm of the 18071 study, were evaluated as reference cohorts. The survival outcomes were compared with the published American Joint Committee on Cancer version 8 (AJCCv8) stage III survival data.

Results: For the CMMR stage III cohort versus the AJCCv8 cohort, the melanoma-specific survival (MSS) rates at 5 years were 67% versus 77%, and at 10 years were 56% versus 69%, respectively. For stage IIIA, the MSS rates at 5 years were 80% versus 93%, and at 10 years were 71% versus 88%; for stage IIIB, the MSS rates at 5 years were 75% versus 83%, and at 10 years were 61% versus 77%. The MSS rates of the EORTC studies either overlapped with or were lower than, the CMMR data.

Conclusion: The MSS rates in the CMMR and EORTC cohorts over the entire stage III are less favorable than those published in AJCCv8. This is particularly true for substages IIIA and IIIB.

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Figures

FIG 1.
FIG 1.
Kaplan-Meier curves for melanoma-specific survival (MSS) in the Central Malignant Melanoma Registry cohort. (A) In all stage III patients. (B) According to American Joint Committee on Cancer version 8 (AJCCv8) classification: stage IIIA, IIIB, IIIC, and IIID. HR, hazard ratio.
FIG 2.
FIG 2.
Kaplan-Meier curves for melanoma-specific survival (MSS) in European Organisation for Research and Treatment of Cancer cohort 18991, observation group. (A) In all stage III patients. (B) According to American Joint Committee on Cancer version 8 (AJCCv8) classification: stage IIIA, IIIB, IIIC, and IIID. HR, hazard ratio.
FIG 3.
FIG 3.
Kaplan-Meier curves for melanoma-specific survival (MSS) in European Organisation for Research and Treatment of Cancer cohort 18071, placebo group. (A) In all stage III patients. (B) According to American Joint Committee on Cancer version 8 (AJCCv8) classification: stage IIIA, IIIB, IIIC, and IIID. HR, hazard ratio.
FIG A1.
FIG A1.
Kaplan-Meier curves for overall survival in the Central Malignant Melanoma Registry cohort. (A) In all stage III patients. (B) According to American Joint Committee on Cancer version 8 (AJCCv8) classification: stage IIIA, IIIB, IIIC, and IIID. HR, hazard ratio.
FIG A2.
FIG A2.
Kaplan-Meier curves for overall survival in the European Organisation for Research and Treatment of Cancer cohort 18991, observation group. (A) In all stage III patients. (B) According to American Joint Committee on Cancer version 8 (AJCCv8) classification: stage IIIA, IIIB, IIIC, and IIID. HR, hazard ratio.
FIG A3.
FIG A3.
Kaplan-Meier curves for overall survival in the European Organisation for Research and Treatment of Cancer cohort 18071, placebo group. (A) In all stage III patients. (B) according to American Joint Committee on Cancer version 8 (AJCCv8) classification: stage IIIA, IIIB, IIIC, and IIID. HR, hazard ratio.
FIG A4.
FIG A4.
Reconstructed melanoma-specific survival curves for patients staged according to American Joint Committee on Cancer version 7 (AJCCv7) and American Joint Committee on Cancer version 8 (AJCCv8) for all stage III patients.
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References

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