Surgical treatment of gastric metastases from cutaneous melanoma: Experience of the National Cancer Institute of Milan

Aim: To evaluate the role of a surgical approach in patients affected with gastric metastases from cutaneous melanoma. Methods: A retrospective review of our local melanoma database of 2100 pati ents identified 31 cases with gastric metastatic deposits. Nine of them wer e considered candidates for surgical resection. Results: Median overall survival of the 9 patients who underwent surgery wa s 14.2 months. Six (67%) underwent a local radical resection of disease, an d 3 (33%) had a simple exploratory laparotomy. The median survival was 21.6 months (range, 4-32 months) for the subset receiving radical surgery and 3 .6 months (range, 2-6 months) for the patients who had no resection. Median follow-up was 14.2 months. No specific correlation of serologic LDH levels and final outcome, as documented elsewhere, was observed. A marked decreas ed or substantial remission of symptoms with an improvement in quality of l ife was observed in all radically resected patients. Conclusions: Patients with gastric metastases from melanoma may benefit fro m surgery if all macroscopic disease can be removed. In addition, gastric r esection in patients with symptomatic melanoma spread to the stomach provid es important symptomatic palliation.