Selected patients with metastatic melanoma may benefit from liver resection.
BACKGROUND
In the last few years there has been expanding use of hepatic resection for non-colorectal metastases. The purpose of this study is to evaluate the experience of liver resection for patients with metastatic melanoma.


METHODS
Eighteen patients with metastatic melanoma were explored for possible surgical resection. All patients fitted the following criteria: absence of extra-hepatic disease after evaluation with CT/MRI and FDG-PET scans; disease-free interval longer than 24 months after the resection of the primary melanoma; presumed completely resectable lesions; absence of clinical co-morbidities.


RESULTS
Liver resection was performed in 10 patients; 8 out of 18 presented with irresectable tumors and/or peritoneal metastases and were not operated. One patient presented with postoperative biliary fistula and was conservatively managed. No other complications or postoperative mortality were observed. After a mean follow-up of 25.4 months, 5 patients are alive and without evidence of recurrence. Overall median survival was 22 months; overall survival and disease-free survival were 70% and 50% respectively.


CONCLUSIONS
Resection of liver metastases from melanoma in a selected group of patients may increase survival. Exploratory laparoscopy should be included in the preoperative armamentarium of diagnostic tools.
Herman
Paulo
P
Department of Abdominal Surgery, A.C. Camargo Cancer Hospital, São Paulo, Brazil. pherman@uol.com.br
Machado
Marcel Autran C
MA
Montagnini
André Luis
AL
D'Albuquerque
Luiz A C
LA
Saad
William A
WA
Machado
Marcel C C
MC
D000328:Adult; D000368:Aged; D005134:Eye Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008545:Melanoma / Q000556:secondary*; D008875:Middle Aged; D018579:Patient Selection; D010534:Peritoneal Neoplasms / Q000556:secondary; D012878:Skin Neoplasms / Q000473:pathology*