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Metastasectomy for recurrent stage IV melanoma
D W Ollila1, E C Hsueh, S L Stern
1Roy E. Coats Research Laboratories and the Division of Surgical Oncology of the John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, California, USA.
Journal of Surgical Oncology
|August 10, 1999
Summary
A second metastasectomy can prolong survival for patients with recurrent stage IV melanoma. Complete surgical resection of all evident tumor is key to improving outcomes in melanoma patients.
Area of Science:
- Oncology
- Surgical Oncology
- Melanoma Research
Background:
- Many patients with stage IV melanoma treated with complete surgical resection experience disease recurrence.
- Recurrent disease in stage IV melanoma poses a significant challenge to long-term survival.
Purpose of the Study:
- To investigate the efficacy of a second metastasectomy in prolonging survival for patients with recurrent stage IV melanoma.
- To identify prognostic factors influencing survival after diagnosis of recurrent stage IV melanoma.
Main Methods:
- Retrospective review of a melanoma database (1971-1995) including 8,750 patients.
- Analysis of 131 patients with recurrent stage IV melanoma who were followed for at least 24 months or until death.
Main Results:
- Median survival was 18.2 months after complete metastasectomy versus 12.5 months (palliative surgery) and 5.9 months (nonsurgical management).
- Five-year survival rates were 20.0% (complete metastasectomy), 7.0% (palliative surgery), and 2.1% (nonsurgical).
- Complete surgical metastasectomy and a prolonged disease-free interval were significant positive prognostic factors (P=0.0001).
Conclusions:
- Complete surgical metastasectomy can significantly prolong survival in patients with recurrent stage IV melanoma.
- The ability to resect all clinically evident tumor is critical for improved survival outcomes.