The role of abdominal resectional surgery in metastatic melanoma.
BACKGROUND
We reviewed our experience to determine the role of resectional surgery in metastatic melanoma to the abdomen.


METHODS
An observational study of 25 patients at the Austin Hospital, Melbourne from 1997 to 2005.


RESULTS
The median survival after abdominal resectional surgery was 8.3 (range 0.4-41.1) months. Fourteen patients who underwent resection with curative intent (extra-abdominal disease controlled and complete macroscopic clearance of abdominal disease) had improved survival compared with 11 patients who underwent palliative resection (12 month survival, 89 vs 10%, respectively, P < 0.0001). Survival was also superior in patients with up to two metastases compared with more than two (P = 0.0001) and in patients with serum albumin of at least 35 g/L (P = 0.0031). Intent of surgery (curative vs palliative) was the only factor significant on multivariate analysis (P = 0.001). Of patients with preoperative symptoms, 87% had resolution of these symptoms. Operative morbidity was 12%, and 30-day mortality was 4%.


CONCLUSIONS
In a highly selected group of patients with intra-abdominal melanoma metastases, resection of intra-abdominal metastases with curative intent resulted in prolonged survival compared with patients who underwent palliative resection. Those who underwent palliative resection had good relief of symptoms with minimal morbidity.
Hodgson
Russell
R
Department of Surgery, University of Melburn, Austin Health, Melbourne, Victoria, Australia. russell.hodgson@gmail.com
Fink
Michael A
MA
Jones
Robert M
RM
D000008:Abdominal Neoplasms / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012044:Regression Analysis; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors