268 Efficacy and Safety Profiles of Surgical Resection in Patients with Metastatic Gynecologic Melanoma on Immune Checkpoint Inhibitors: A Retrospective Cohort Study
Bibliographic record
Abstract
Abstract Introduction Malignant vulvovaginal melanoma is a rare, aggressive malignancy with poor prognosis and no consensus regarding treatment. Few studies to date have comprehensively examined the efficacy and safety of surgical procedures alongside immunotherapy in their treatment. Method We retrospectively analyzed 169 patients with advanced-stage metastatic melanoma who received at least one dose of immunotherapy between June 2012 to December 2018. Descriptive statistics were used, as well as Chi-square statistical analysis to examine associations between immune-related adverse events (irAEs) and treatment response. P-values <0.05 were statistically significant. Results Surgical resection was performed in 63.6% of patients with vulvovaginal melanoma, which was comparable to other melanoma subtypes. From patients with vulvovaginal melanoma who received prior surgery, 80% had progressive disease and 20% response to treatment, compared with 100% progression in patients without prior surgery. Furthermore, patients with vulvovaginal melanoma developed irAEs in 53.8% of the cases. Cutaneous adverse events were overall the most common irAEs and were significantly associated with patient response to ICIs (p = 0.01). Conclusions The majority of patients received surgery prior to immunotherapy. Those who received prior surgery had greater response to immunotherapy compared to those without prior surgery. Surgery and immunotherapy is a unique therapeutic regime to control metastatic vulvovaginal melanoma.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".