Laparoscopy in the abdominal staging of melanoma

A retrospective study on laparoscopic results in the abdominal staging of 297 patients with melanoma, is reported. In 195 (99.3%) of patients, laparoscopy was technically feasible, and in 10% the clinical stage was changed on the basis of the findings. In 34% of patients with metastasis of the liver and peritoneum, the tumor had a diameter of under 1 cm and therefore was not detectable with non-invasive techniques. In the light of these results laparoscopy is advisable in patients with Stage I melanoma at a high risk of metastatization (Clark IV-V; Breslow greater than 0.76 mm) and in Stage II patients. In Stage III patients, laparoscopy seems indicated for an evaluation of the efficacy of systemic treatment.