title: Emergency surgery for metastatic melanoma.
abstract: Visceral metastases from malignant melanoma (stage M1c) confer a very poor prognosis, as documented on the most recent revised version of the TNM/AJCC staging system. Emergency surgery for intra-abdominal complications from the disease is rare. We report on our 5-year single institution experience with surgical management of metastatic melanoma to the viscera in the emergent setting. From 2009 to 2013, 14 patients with metastatic melanoma were admitted emergently due to an acute abdomen. Clinical manifestations encompassed intestinal obstruction and bleeding. Surgical procedures involved multiple enterectomies with primary anastomoses in 8 patients, and one patient underwent splenectomy, one adrenalectomy, one right colectomy, one gastric wedge resection, one gastrojejunal anastomosis, and one transanal debulking, respectively. The 30-day mortality was 7 percent. Median follow-up was 14 months. Median overall survival was 14 months. Median disease free survival was 7.5 months. One-year overall survival was 64.2 percent and 2-year overall survival was 14.2 percent. Emergency surgery for metastatic melanoma to the viscera is rare. Elective curative surgery combined with novel cytotoxic systemic therapies is under investigation in an attempt to grant survival benefit in melanoma patients with visceral disease.
authors.affiliation: 2nd Propaedeutic Department of Surgery, Laiko General Hospital, Athens University School of Medicine, 17 Agiou Thoma Street, 11527 Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Mantas
authors.affiliation: 2nd Propaedeutic Department of Surgery, Laiko General Hospital, Athens University School of Medicine, 17 Agiou Thoma Street, 11527 Athens, Greece.
authors.forename: Petros
authors.initials: P
authors.lastname: Tsaparas
authors.affiliation: 2nd Propaedeutic Department of Surgery, Laiko General Hospital, Athens University School of Medicine, 17 Agiou Thoma Street, 11527 Athens, Greece.
authors.forename: Petros
authors.identifier: 0000-0003-1086-3785
authors.initials: P
authors.lastname: Charalampoudis
authors.affiliation: 1st Internal Medicine Department, Laiko General Hospital, Athens University School of Medicine, 17 Agiou Thoma Street, 11527 Athens, Greece.
authors.forename: Helen
authors.initials: H
authors.lastname: Gogas
authors.affiliation: 2nd Propaedeutic Department of Surgery, Laiko General Hospital, Athens University School of Medicine, 17 Agiou Thoma Street, 11527 Athens, Greece.
authors.forename: Gregory
authors.initials: G
authors.lastname: Kouraklis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007414:Intestinal Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*; D015996:Survival Rate / Q000639:trends; D055815:Young Adult