title: The role of surgery in the treatment of nonregionally recurrent melanoma.
abstract: BACKGROUND
  Between 1971 and 1989, 144 patients underwent 183 surgical procedures for resection of nonregional metastatic melanoma.
  
  
  METHODS
  Thirty-six patients with subcutaneous or nodal metastases, 46 patients with pulmonary metastases, 17 patients with brain metastases, 19 with gastrointestinal metastases, and 26 patients with miscellaneous sites of metastatic involvement underwent resection.
  
  
  RESULTS
  The overall 5- and 10-year actuarial survival rates were 20% and 14%, respectively. A single postoperative death occurred in a patient operated on for palliative treatment of gastrointestinal metastases.
  
  
  CONCLUSIONS
  Cox regression analysis suggests that patients with a solitary metastasis confined to the subcutaneous, nonregional lymph nodes or lung are most likely to benefit from aggressive surgical intervention. Surgical intervention represents a potentially important modality in the management of selected patients with nonregional metastatic melanoma.
authors.affiliation: Department of Surgery, John Wayne Cancer Clinic, Jonsson Comprehensive Cancer Center, University of California, Los Angeles.
authors.forename: J H
authors.initials: JH
authors.lastname: Wong
authors.forename: K A
authors.initials: KA
authors.lastname: Skinner
authors.forename: K A
authors.initials: KA
authors.lastname: Kim
authors.forename: L J
authors.initials: LJ
authors.lastname: Foshag
authors.forename: D L
authors.initials: DL
authors.lastname: Morton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003399:Craniotomy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008545:Melanoma / Q000601:surgery*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D013908:Thoracotomy