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Pulmonary Metastasectomy for Melanoma.

Philicia Moonsamy1, Eliza Hompe1, Genevieve M Boland2

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Thoracic Surgery Clinics
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Melanoma survival drops with metastasis, but new therapies and surgical criteria improve outcomes. Thoracic surgeons play a key role in selecting patients for pulmonary metastasectomy.

Keywords:
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Area of Science:

  • Oncology
  • Surgical Oncology
  • Pulmonary Medicine

Background:

  • Early-stage melanoma offers a high survival rate (94%), but metastatic disease drastically reduces prognosis.
  • Metastatic melanoma survival rates have significantly improved, rising from 18% in 2009 to 52% in 2018 due to targeted therapies and immune checkpoint inhibitors.
  • The lung is the most frequent site for melanoma metastasis.

Purpose of the Study:

  • To review the evolving criteria for pulmonary metastasectomy in melanoma.
  • To highlight the role of thoracic surgeons in the multidisciplinary management of metastatic melanoma.
  • To emphasize the impact of advanced therapies on surgical candidacy.

Main Methods:

  • Review of current literature on melanoma metastasis and treatment outcomes.
  • Analysis of changes in surgical indications for pulmonary metastasectomy.
  • Discussion of the integration of systemic therapies with surgical interventions.

Main Results:

  • Significant improvement in 5-year survival for metastatic melanoma patients treated with modern therapies.
  • Expanded criteria for pulmonary metastasectomy, including cases with extrapulmonary metastasis if complete resection is feasible.
  • Increased importance of thoracic surgeons in patient selection and surgical planning.

Conclusions:

  • Advances in targeted therapy and immunotherapy have transformed metastatic melanoma treatment.
  • Pulmonary metastasectomy remains a critical intervention, with evolving indications.
  • A multidisciplinary approach integrating thoracic surgery and systemic therapies optimizes outcomes for metastatic melanoma.