ADJUVANT TREATMENT IN STAGE-I AND STAGE-II MALIGNANT-MELANOMA - A RANDOMIZED TRIAL BETWEEN CHEMOIMMUNOTHERAPY AND IMMUNOTHERAPY

A randomized trial comparing chemoimmunotherapy (bacillus Calmette-Guerin + chemotherapy) and immunotherapy (bacillus Calmette-Guerin alone) was carried out in high-risk stage I and II malignant melanoma patients. Eighty-two evaluable patients were included. The follow-up median duration was 11 years. Recurrent melanoma developed in 28 patients (34%). The overall survival rate was 76% at 5 years and 65% at 10 years. There were no statistical differences in survival probability or disease-free survival (DFS) probability between the two treatment groups. Survival and DFS were also analyzed in relation to various prognostic factors. Statistically significant differences were only seen in a subset of 33 patients with lower limb malignant melanoma, the prognosis being better for the chemoimmunotherapy group in this location. Because of the small number of patients in each group, a week positive effect of either of these two treatments cannot be ruled out. Chemoimmunotherapy only seems to improve the prognosis of stage I or II malignant melanoma of the legs.