Arak H.Erkiliç S.Yaslikaya Ş.Eylemer Mocan E.Aktaş G.Özdemir M.Semiz H.S.Kiliçkap S.Özalp F.R.Sever Ö.N.Akdaǧ G.Aǧaoǧlu A.B.Özçelik M.Sari M.Arcagök M.Anik H.Yayla Ş.B.Sever N.Açar F.P.Bayrakçi İ.Turhal S.Ayhan M.Kuş T.2024-07-222024-07-22202415249557http://akademikarsiv.cbu.edu.tr:4000/handle/123456789/11318Our aim was to assess the efficacy of adjuvant programmed cell death protein-1 (PD-1) inhibitors and compare the other adjuvant treatments in patients with surgically resected stage III or IV acral melanoma. This study is a multicenter, retrospective analysis. We included 114 patients with stage III or IV acral malignant melanoma who underwent surgery within the past 10 years. We analyzed the effect of adjuvant programmed cell death protein-1 inhibitors on disease-free survival (DFS). The mean follow-up was 40 months, during which 69 (59.5%) patients experienced recurrence. Among the participants, 64 (56.1%) received systemic adjuvant therapy. Specifically, 48.4% received anti-PD-1 therapy, 29.7% received interferon, 14.1% received tezozolomide, and 7.8% received B-Raf proto-oncogene/mitogen-activated protein kinase inhibitors. Patients who received adjuvant therapy had a median DFS of 24 (10.9-37.2) months, whereas those who did not receive adjuvant therapy had a median DFS of 15 (9.8-20.2) months. Multivariate analysis for DFS revealed that the receipt of adjuvant therapy and lymph node metastasis stage were independent significant parameters (P = 0.021, P = 0.018, respectively). No statistically significant difference was observed for DFS between programmed cell death protein-1 inhibitor treatment and other adjuvant treatments. Regarding overall survival (OS), patients who received adjuvant treatment had a median OS of 71 (30.4-111.7) months, whereas those who did not receive adjuvant treatment had a median OS of 38 (16.7-59.3; P = 0.023) months. In addition, there were no significant differences in OS observed between various adjuvant treatment agents (P = 0.122). In our study, we have shown that adjuvant therapy had a positive effect on both DFS and OS in patients with stages III-IV acral melanoma who underwent curative intent surgery. Notably, we found no significant differences between anti-PD-1 therapy and other adjuvant therapies. © 2024 Lippincott Williams and Wilkins. All rights reserved.EnglishAll Open Access; Hybrid Gold Open AccessAdultAgedAged, 80 and overChemotherapy, AdjuvantFemaleHumansImmune Checkpoint InhibitorsMaleMelanomaMiddle AgedNeoplasm StagingProgrammed Cell Death 1 ReceptorProto-Oncogene MasRetrospective StudiesSkin NeoplasmsTreatment OutcomeB Raf kinasecarboplatindabrafenibinterferonipilimumablactate dehydrogenasemitogen activated protein kinasenivolumabpaclitaxelpembrolizumabprogrammed death 1 receptortemozolomidetrametinibimmune checkpoint inhibitorMAS receptorMAS1 protein, humanPDCD1 protein, humanprogrammed death 1 receptoracral melanomaadultagedArticlecancer adjuvant therapycancer stagingcancer survivalclinical assessmentcomparative studycontrolled studydisease free survivaldistant metastasisdrug efficacyfemalefollow uphumanlymph node metastasismajor clinical studymalemelanomamiddle agedmulticenter study (topic)multiple cycle treatmentmultivariate analysisobservational studyoverall survivalpersonal experienceretrospective studystatistically significant resulttreatment durationtreatment indicationtumor localizationvery elderlyadjuvant chemotherapyclinical trialmelanomamortalitymulticenter studypathologyproceduresskin tumortreatment outcomeArticle10.1097/CJI.0000000000000508