Lynn T Dengel1, Craig L Slingluff. 1. Department of Surgery, University of Virginia Health Systems, Charlottesville, Virginia 22908, USA.
Abstract
BACKGROUND: Metastatic melanoma to abdominal and retroperitoneal viscera carries a poor prognosis possibly resulting in reluctance to offer surgical management. There is value in defining the morbidity of such surgery. METHODS: Review of a prospectively maintained database identified patients with metastatic melanoma to abdominal or retroperitoneal viscera who underwent surgery from 9/99 to 8/06. RESULTS: Nineteen patients underwent surgery for metastasis to abdominal or retroperitoneal viscera detected by clinical symptoms (80%), or imaging (20%). The median length of stay was 7 days. There was no perioperative mortality. Surgical complications occurred in four patients. At initial follow-up, 13 patients (68%) had returned to baseline function, 7 of which reported improvement. Four patients (21%) had minimal symptoms, and only two patients (11%) had significantly limited function. Median follow-up was 35 months, at which time 9 of the 19 patients (47%) were still alive, with 3- and 5-year Kaplan-Meier survival estimates of 53% (SE 12) and 45% (SE 12), respectively, and 2 of the 19 patients are alive at over 8 years since surgery. CONCLUSION: In selected cases, surgery may have both palliative benefit and curative potential for patients with visceral metastases of melanoma. Surgical management of such patients should be encouraged in appropriate clinical settings.
BACKGROUND:Metastatic melanoma to abdominal and retroperitoneal viscera carries a poor prognosis possibly resulting in reluctance to offer surgical management. There is value in defining the morbidity of such surgery. METHODS: Review of a prospectively maintained database identified patients with metastatic melanoma to abdominal or retroperitoneal viscera who underwent surgery from 9/99 to 8/06. RESULTS: Nineteen patients underwent surgery for metastasis to abdominal or retroperitoneal viscera detected by clinical symptoms (80%), or imaging (20%). The median length of stay was 7 days. There was no perioperative mortality. Surgical complications occurred in four patients. At initial follow-up, 13 patients (68%) had returned to baseline function, 7 of which reported improvement. Four patients (21%) had minimal symptoms, and only two patients (11%) had significantly limited function. Median follow-up was 35 months, at which time 9 of the 19 patients (47%) were still alive, with 3- and 5-year Kaplan-Meier survival estimates of 53% (SE 12) and 45% (SE 12), respectively, and 2 of the 19 patients are alive at over 8 years since surgery. CONCLUSION: In selected cases, surgery may have both palliative benefit and curative potential for patients with visceral metastases of melanoma. Surgical management of such patients should be encouraged in appropriate clinical settings.
Authors: T F Wood; L A DiFronzo; D M Rose; P I Haigh; S L Stern; L Wanek; R Essner; D L Morton Journal: Ann Surg Oncol Date: 2001-09 Impact factor: 5.344
Authors: D F Roses; N S Karp; R Oratz; N Dubin; M N Harris; J Speyer; A Boyd; F M Golomb; J Ransohoff; M Dugan Journal: Surg Gynecol Obstet Date: 1991-04
Authors: P Mariani; S Piperno-Neumann; V Servois; M G Berry; T Dorval; C Plancher; J Couturier; C Levy-Gabriel; L Lumbroso-Le Rouic; L Desjardins; R J Salmon Journal: Eur J Surg Oncol Date: 2009-03-28 Impact factor: 4.424