Surgery in recurrent malignant melanoma

Seventy-nine consecutive patients with resectable, recurrent malignant melanoma were treated with surgical excision, followed by adjuvant chemotherapy. Of 7 Stage IIIA patients, 6 remain alive; 5 are disease-free at 27 months. Of 33 patients with advanced stage IIIB disease with fixed tumor masses, including 16 cases that involved two nodal groups, 10 patients (30%) remain disease-free at 30 months. Of 12 Stage IIIAB patients, one remains disease-free at 26 months. Of 27 Stage IV patients, 7 (25%) remain disease-free at 36 months. Characteristic of those patients who remain disease-free is the initial presence of 3 or less discrete metastatic lesions, and a long prior disease-free interval. Surgical removal of metastatic lesions of malignant melanoma, in combination with chemotherapy, offers improved palliation in patients with a small number of metastatic lesions and a long previous disease-free interval.