Improved survival after resection of pulmonary metastases from malignant melanoma

• Published in: The Annals of thoracic surgery Vol. 52; no. 2; pp. 204 - 210
• Main Authors: Gorenstein, Lyall A., Putnam, Joe B., Natarajan, Giri, Balch, Charles A., Roth, Jack A.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.08.1991
• Subjects: Female; Humans; Lung Neoplasms - mortality; Lung Neoplasms - secondary; Lung Neoplasms - surgery; Lymph Node Excision; Male; Melanoma - mortality; Melanoma - pathology; Melanoma - secondary; Melanoma - surgery; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Prognosis; Retrospective Studies; Skin Neoplasms - pathology; Survival Analysis
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/0003-4975(91)91337-U

The value of resecting pulmonary metastases from malignant melanoma was retrospectively examined. Between 1981 and 1989, 56 patients (35 men and 21 women with a mean age of 49 years) had 65 pulmonary resections for histologically proven metastatic melanoma after treatment of the primary tumor. In patients undergoing thoracotomy, 50% ( 28 / 56 ) had pulmonary metastases as the initial site of recurrence. Twenty-eight patients (50%) had local-regional recurrence before the development of lung metastases. Eight lobectomies, two segmentectomies, and 55 wedge excisions were done. Fifty-four patients ( 54 / 56 , 96%) underwent complete resection, and there were no operative deaths. The postthoracotomy actuarial survival was 25% at 5 years (median interval, 18 months). Location of the primary tumor, histology, thickness, Clark level, local-regional lymph node metastases, or type of resection was not associated with improved survival. Patients without regional nodal metastases before thoracotomy had a median survival of 30 months compared with 16 months for all others ( p = 0.04). Patients with lung as the site of first recurrence had a median survival of 30 months compared with 17 months for patients with initial local-regional recurrence ( p = 0.038, log-rank test). Despite systemic spread, patients with isolated pulmonary metastases from melanoma may benefit from metastasectomy.