METASTASECTOMY IN MALIGNANT-MELANOMA

Background. Resection of distant metastases in melanoma is occasionall y helpful. The extent of applicability of this treatment, the benefit derived, and the prognostic parameters aiding in the selection of the patients need to be defined further. Methods. The cases of one hundred fourteen patients with resected distant metastases were reviewed and subjected to multivariate analysis. Results. The median survival after metastasectomy was 19 months and the estimated 5-year survival rate w as 22%. The 5-year survival rate was 33% for those with distant subcut aneous metastases, 22% for those with distant lymph node metastases, a nd 14% for those with pulmonary metastases (p = 0.12). Twenty patients (18%) are disease free at a median follow-up of 106 months. Significa nt prognostic parameters were the thickness of the primary melanoma (p = 0.05), the number of metastatic lesions (p = 0.03), and the prior d isease-free interval (p = 0.05). Conclusions. Resection of distant met astases is applicable in about one fourth of patients patients with di sseminated melanoma. With adherence to certain selection criteria the resulting 5-year survival rate is appreciable and higher than that aft er other, currently available treatments.