Role of surgery for metastatic malignant melanoma: a review

The role of surgery in the management of metastatic melanoma is reviewed. Favorable prognostic factors include a longer disease free interval, single site of disease, complete resection, and nonvisceral metastases. Patients undergoing complete resection of remote nonvisceral metastases have a median survival of 17-50 months, and a 5-year survival (5YS) of 9-35%. Patients with pulmonary metastases are usually asymptomatic; complete resection results in a median survival of 8-20 months, and a 5YS of 10-25%. In contrast, patients with metastases to brain or gastrointestinal tract are usually symptomatic; resection offers good palliation, but their median survival is only 7-10 months with few long-term survivors. The key to effective surgical management of patients with metastatic melanoma is careful patient selection.