Surgical Resection for Metastatic Melanoma to the Liver

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Abstract
THE PROGNOSIS of patients with American Joint Committee on Cancer (AJCC) stage IV melanoma is dismal, with a median survival of 4 to 6 months and an actuarial 5-year survival of 6%.1 The optimal treatment for advanced melanoma remains in evolution, as neither chemotherapy nor immunotherapy have yet been shown to alter outcome. There is increasing evidence to support the judicious use of surgical resection in appropriately selected patients. Depending on the anatomic site, median overall survival (OS) rates between 24 and 49 months have been reported following complete resection of pulmonary,2-7 gastrointestinal,7-10 and adrenal metastases.11,12 Some patients have had prolonged survival following repeated metastasectomy, suggesting that there is even a smaller subgroup of patients with advanced disease who can be salvaged by surgery.13