Surgical Management of Melanoma Lung Metastasis: An Analysis of Survival Outcomes in 292 Consecutive Patients

Background The role of surgical resection of melanoma lung metastases (MLM) remains controversial. Some authorities advocate an aggressive surgical approach, while others recommend a conservative strategy. This study sought to identify the clinicopathologic and predictors of outcome after surgical m...

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Bibliographic Details
Published in:Annals of surgical oncology 2012-06, Vol.19 (6), p.1774-1781
Main Authors: Chua, Terence C., Scolyer, Richard A., Kennedy, Catherine W., Yan, Tristan D., McCaughan, Brian C., Thompson, John F.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Lung Neoplasms - mortality
Lung Neoplasms - secondary
Lung Neoplasms - surgery
Male
Medicine
Medicine & Public Health
Melanoma - mortality
Melanoma - pathology
Melanoma - surgery
Melanomas
Metastasectomy
Middle Aged
Neoplasm Staging
Oncology
Pneumonectomy
Prognosis
Prospective Studies
Retrospective Studies
Surgery
Surgical Oncology
Survival Rate
Young Adult
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Summary:Background The role of surgical resection of melanoma lung metastases (MLM) remains controversial. Some authorities advocate an aggressive surgical approach, while others recommend a conservative strategy. This study sought to identify the clinicopathologic and predictors of outcome after surgical management of MLM in a large series of melanoma patients from a single institution. Methods All patients undergoing surgical management of MLM between November 1984 and April 2010 were identified and predictors of outcome analyzed. Results Of the 292 patients eligible for the study, 112 (38%) had previously undergone surgery for nonpulmonary recurrences. Four patients (1%) died within 30 days of surgery for MLM. The median progression-free survival time was 10 months. The median overall survival and 3- and 5-year survival were 23 months [95% confidence interval (CI) 17–30], 41 and 34%, respectively. Metastasis size >2 cm [hazard ratio (HR) 1.4, 95% CI 1.0–1.8, P  = 0.03, HR 1.6, 95% CI 1.2–2.2; P  = 0.002] and positive surgical margin (HR 1.5, 95% CI 1.2–1.9, P  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-011-2197-y