Treatment of Malignant Melanoma

Our plain-English summary of Treatment of Malignant Melanoma, by A. Ochsner (1965).

The study

• Author: A. Ochsner
• Published: Postgraduate Medicine, April 1965.
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This article concerns malignant melanoma, not asbestos. In a talk, the author, of the Ochsner Clinic, New Orleans, reported on 203 consecutive patients with proved melanoma and one case report. Patients were grouped by treatment. Groups 1 and 2 were treated at the clinic from diagnosis or soon after. Group 3 had first treatment elsewhere, almost invariably inadequate, but no evidence of distant metastases. Group 4 (61 per cent) already had metastases. When the study was made, 26 per cent overall were living and free from disease; 73 per cent of groups 1 and 2, 33 per cent of group 3 and 6 per cent of group 4 were living. Some patients disease-free at five years later died of melanoma. Larger shares of women than men, and of patients under 50 than over 50, were alive. In the case report, a woman whose melanoma had reached the armpit lived 24 years after wide surgery. The author concluded that melanoma is highly malignant and unpredictable, but need not be hopeless if properly treated. The author noted poorer follow-up in this series than for other cancers.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Clinical case series from one clinic, presented as a lecture, with one illustrative case report
• Who was studied: 203 consecutive patients with proved malignant melanoma seen at the Ochsner Clinic, New Orleans (dates not given); 55 per cent male, 45 per cent female; divided into four treatment groups (group 1, 13 per cent; group 2, 12 per cent; group 3, 14 per cent; group 4, with metastases at first visit, 61 per cent)
• Exposure: No asbestos exposure is studied. The article concerns melanoma treatment: wide excision, wide enough to require grafting, with dissection of regional lymph nodes; group 4 received excision of solitary metastases and chemotherapy
• Main results:
  • At the time of the study, 26 per cent of all patients were living and free from disease. By group, 73 per cent in groups 1 and 2, 33 per cent in group 3 and 6 per cent in group 4 were living (the article does not state that these group figures are disease-free)
  • Alive at five and ten years: groups 1 and 2, 64 and 55 per cent; group 3, 27 and 26 per cent; group 4, 2 and 1 per cent
  • Patients aged 20 to 29: 53 per cent alive at five years and 42 per cent at ten years, with 11 per cent more dying of melanoma in the second five years
  • Overall, 32 per cent of those treated over five years previously were alive and apparently free from disease at five years, but only 17 per cent were still living at the time of the report
  • By sex, the article states that of the survivors, 19 per cent are males and 34 per cent are females; 72 per cent of males and 54 per cent of females were known to be dead
  • By age, 33 per cent of patients under 50 were alive and free from disease, compared with 18 per cent of those over 50
  • Case report: a woman whose cauterized arm mole proved to be melanoma involving the axillary nodes and pectoral muscles had wide excision and axillary dissection, and was alive and apparently well 24 years later
• The authors' conclusion: The author concluded that melanoma is a highly malignant and unpredictable disease, but that if it is treated properly the prognosis need not be hopeless, and that prognosis should be guarded
• Limitations the authors state:
  • The author states that follow-up in this series was not as good as for patients with other malignant diseases

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