Metastasectomy in malignant melanoma.
BACKGROUND
Resection of distant metastases in melanoma is occasionally helpful. The extent of applicability of this treatment, the benefit derived, and the prognostic parameters aiding in the selection of the patients need to be defined further.


METHODS
The cases of one hundred fourteen patients with resected distant metastases were reviewed and subjected to multivariate analysis.


RESULTS
The median survival after metastasectomy was 19 months and the estimated 5-year survival rate was 22%. The 5-year survival rate was 33% for those with distant subcutaneous metastases, 22% for those with distant lymph node metastases, and 14% for those with pulmonary metastases (p = 0.12). Twenty patients (18%) are disease free at a median follow-up of 106 months. Significant prognostic parameters were the thickness of the primary melanoma (p = 0.05), the number of metastatic lesions (p = 0.03), and the prior disease-free interval (p = 0.05).


CONCLUSIONS
Resection of distant metastases is applicable in about one fourth of patients with disseminated melanoma. With adherence to certain selection criteria the resulting 5-year survival rate is appreciable and higher than that after other, currently available treatments.
Karakousis
C P
CP
Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263.
Velez
A
A
Driscoll
D L
DL
Takita
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery; D005163:Factor Analysis, Statistical; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery; D008197:Lymph Node Excision; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D011379:Prognosis; D016016:Proportional Hazards Models; D012878:Skin Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery; D016019:Survival Analysis; D015996:Survival Rate