title: Liver resection and ablation for metastatic melanoma: A single center experience.
abstract: BACKGROUND
  The median survival for patients with stage IV metastatic melanoma is usually limited to approximately 1 year. In the case of liver metastasis, resection and ablation can achieve long-term survival. This study aimed to describe the outcomes after liver resection or ablation for metastatic melanoma to the liver and identify preoperative prognostic factors.
  
  
  METHODS
  Forty eight patients who underwent liver resection (n = 32) or percutaneous ablation (n = 16) were identified from the 1,523 patients with melanoma liver metastases evaluated between January1993 and January 2013.
  
  
  RESULTS
  Median OS was 25.9 months. Median OS was not different after ablation (18 months) and resection (26 months; P > 0.2). Patients in the ablation group more often presented with extrahepatic disease (EHD) (P = 0.008) and received more frequently systemic therapy before ablation (P = 0.005). Patients without EHD tended to have longer OS (26.5 vs. 12 months; P = 0.076) and PFS (13 vs. 5 months; P = 0.11) in the whole cohort. EHD was significantly associated with a worse OS in the resection group (P = 0.034).
  
  
  CONCLUSIONS
  Liver resection is associated to prolonged survival over 24 months and should be considered only in selected patients with metastatic disease confined to the liver. In patients not candidate for surgery, tumor ablation can be considered.
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Doussot
authors.affiliation: Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.|Weill Cornell Medical College, New York, New York.
authors.forename: Charlée
authors.initials: C
authors.lastname: Nardin
authors.affiliation: Department of Interventional Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Takaki
authors.affiliation: Department of Interventional Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Tess D
authors.initials: TD
authors.lastname: Litchman
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Michael I
authors.initials: MI
authors.lastname: D'Angelica
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: William R
authors.initials: WR
authors.lastname: Jarnagin
authors.affiliation: Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.|Weill Cornell Medical College, New York, New York.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Postow
authors.affiliation: Department of Interventional Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Erinjeri
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: T Peter
authors.initials: TP
authors.lastname: Kingham
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000473:pathology / Q000601:surgery; D008113:Liver 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*; D016019:Survival Analysis; D055815:Young Adult
keywords: ablation therapy; extrahepatic disease; liver resection; melanoma liver metastasis