Prognostic factors in stage IV malignant melanoma.

To identify factors that are prognostic for survival in patients with stage IV malignant melanoma, a retrospective analysis was performed at the authors' institutions between 1976 and 1999. The median survival time of 53 stage IV patients was 7.1 months. Univariate analysis showed that initial site of metastasis (p=0.05) was significant prognostic factor. Conversely, the stage of disease preceding distant metastasis (p=0.59), disease free interval before distant metastasis (p=0.66), times at distant metastasis (p=0.92), and treatment modalities (p=0.17) were not significantly prognostic for survival. The response rates to DAV (dacarbazine, nimustine, vincristine), CDV (cisplatin, dacarbazine, vindesine), and DACTam (dacarbazine, nimustine, cisplatin, tarnoxifen) regimens were 22.2%, 9.1%, 0%, respectively. There was no statistically significant difference in response rates among the treatment arms (p=0.23). Although a variety of chemotherapeutic drug combinations have been explored over the years, they have not proven to be superior to dacarbazine alone. We need to develop new strategies for the treatment of stage IV melanoma. [Skin Cancer (Japan) 2001; 16: 222-227]