title: Resection of Gastrointestinal Metastases in Stage IV Melanoma: Correlation with Outcomes.
abstract: The prognosis of patients with gastrointestinal (GI) melanoma metastases is poor. Surgery renders select patients disease free and/or palliates symptoms. We reviewed our single-institution experience of resection with GI melanoma metastases. A retrospective review was performed on patients who underwent surgery for GI melanoma metastases from 2007 to 2013. Fifty-four patients were identified and separated based on completeness of resection into curative 13 (24%) and palliative 41 (75.9%) groups. Thiry-six (63.2%) were symptomatic preoperatively with bleeding and/or obstruction/pain with 91.7 per cent achieving objective symptom relief. Thirty-day operative mortality was 0 per cent. The most common complication was wound infection (n = 5); major complications like anastomotic leak (n = 1) were uncommon. With a median follow-up of 9.5 months (range 0.2-75.8), median overall survival was not reached (curative) versus 9.53 months (palliative group). Median recurrence-free and progression-free survival after resection were 18.89 and 1.97 months in the curative versus palliative groups, respectively. On multivariate analysis, resection to no clinical evidence of disease (P = 0.012) and presence of single metastases (P = 0.031) were associated with improved overall survival. Surgery for GI metastases from melanoma provides symptomatic relief without major morbidity. Fewer metastases and curative resection were associated with improved survival.
authors.affiliation: Department of Cutaneous Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
authors.forename: Sangeetha
authors.initials: S
authors.lastname: Prabhakaran
authors.forename: William J
authors.initials: WJ
authors.lastname: Fulp
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Gonzalez
authors.forename: Vernon K
authors.initials: VK
authors.lastname: Sondak
authors.forename: Ragini R
authors.initials: RR
authors.lastname: Kudchadkar
authors.forename: Geoffrey T
authors.initials: GT
authors.lastname: Gibney
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Weber
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Zager
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001163:Arteriovenous Anastomosis; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008875:Middle Aged; D015999:Multivariate Analysis; D010166:Palliative Care; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection; D013997:Time Factors; D055815:Young Adult