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Isolated Hepatic Perfusion as a Treatment for Liver Metastases of Uveal Melanoma
Published on: January 25, 2015
14.1K
Emergency surgery for metastatic melanoma
Dimitrios Mantas1, Petros Tsaparas1, Petros Charalampoudis1
12nd Propaedeutic Department of Surgery, Laiko General Hospital, Athens University School of Medicine, 17 Agiou Thoma Street, 11527 Athens, Greece.
International Journal of Surgical Oncology
|December 23, 2014
Summary
Emergency surgery for visceral melanoma metastases (stage M1c) is rare but can be life-saving. This study details surgical management and outcomes for 14 patients, offering insights into survival benefits for advanced melanoma.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Visceral metastases in malignant melanoma (stage M1c) are associated with a poor prognosis.
- Emergency surgery for intra-abdominal complications of metastatic melanoma is infrequently documented.
- The TNM/AJCC staging system highlights the severity of stage M1c disease.
Purpose of the Study:
- To report a 5-year single-institution experience with the surgical management of metastatic melanoma to the viscera in an emergent setting.
- To analyze clinical manifestations, surgical procedures, and survival outcomes in patients undergoing emergency surgery for visceral melanoma.
- To evaluate the role and feasibility of emergency surgical interventions for acute abdominal complications in advanced melanoma.
Main Methods:
- A retrospective review of 14 patients with metastatic melanoma admitted emergently due to acute abdomen between 2009 and 2013.
- Analysis of clinical presentations including intestinal obstruction and bleeding.
- Documentation of surgical procedures performed, such as enterectomies, splenectomy, adrenalectomy, colectomy, gastric resection, and debulking.
Main Results:
- The 30-day mortality rate was 7%.
- Median overall survival was 14 months, with a median disease-free survival of 7.5 months.
- One-year overall survival was 64.2%, and 2-year overall survival was 14.2%.
Conclusions:
- Emergency surgery for visceral metastatic melanoma, while rare, can be a necessary intervention for acute abdominal complications.
- The study provides valuable data on survival outcomes following emergency surgical management in this challenging patient population.
- Further research into elective curative surgery combined with systemic therapies is warranted to improve survival benefits for melanoma patients with visceral disease.
