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Br J Cancer. 2000 September; 83(5): 569–572.
Published online 2000 August 16. doi:  10.1054/bjoc.2000.1335
PMCID: PMC2363508

Lung metastases from melanoma: when is surgical treatment warranted?


Surgical treatment of lung metastases from melanoma is highly controversial as the expected outcome is much poorer than for other primary tumours and a reliable system for selecting patients is lacking. This study evaluated the long-term results of lung metastasectomy for melanoma, with the aim of defining a subset of patients with better prognosis. By reviewing the data of the International Registry of Lung Metastases (IRLM), we identified 328 patients who underwent lung metastasectomy for melanoma in the period 1945–1995. Survival was calculated by Kaplan–Meier estimate, using log-rank test and Cox regression model for statistical analysis. After complete pulmonary metastasectomy (282 patients) the 5- and 10-year survival was 22% and 16%, respectively. In this group of patients, a time to pulmonary metastases (TPM) shorter than 36 months or the presence of multiple metastases were independent unfavourable prognostic factors. There were no long-term survivors after incomplete resection (46 patients, P< 0.01). Using the IRLM grouping system, patients without risk factors (TPM > 36 months and single lesion) experienced the best survival (29% at 5 years), followed by those with one risk factor only (20% at 5 years). On the other hand, those with two risk factors or incomplete resection showed a significantly poorer survival (7% and 0% at 5 years). Surgery plays an important role in carefully selected cases of pulmonary metastatic melanoma. The prognostic grouping system proposed by the International Registry of Lung Metastases provides a simple and effective method for improving the selection of surgical candidates. © 2000 Cancer Research Campaign

Keywords: pulmonary metastatic melanoma, metastasectomy

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Cahan WG. Excision of melanoma metastases to lung: problems in diagnosis and management. Ann Surg. 1973 Dec;178(6):703–709. [PubMed]
  • Falkson CI, Ibrahim J, Kirkwood JM, Coates AS, Atkins MB, Blum RH. Phase III trial of dacarbazine versus dacarbazine with interferon alpha-2b versus dacarbazine with tamoxifen versus dacarbazine with interferon alpha-2b and tamoxifen in patients with metastatic malignant melanoma: an Eastern Cooperative Oncology Group study. J Clin Oncol. 1998 May;16(5):1743–1751. [PubMed]
  • Fletcher WS, Pommier RF, Lum S, Wilmarth TJ. Surgical treatment of metastatic melanoma. Am J Surg. 1998 May;175(5):413–417. [PubMed]
  • Gorenstein LA, Putnam JB, Natarajan G, Balch CA, Roth JA. Improved survival after resection of pulmonary metastases from malignant melanoma. Ann Thorac Surg. 1991 Aug;52(2):204–210. [PubMed]
  • Harpole DH, Jr, Johnson CM, Wolfe WG, George SL, Seigler HF. Analysis of 945 cases of pulmonary metastatic melanoma. J Thorac Cardiovasc Surg. 1992 Apr;103(4):743–750. [PubMed]
  • Holder WD, Jr, White RL, Jr, Zuger JH, Easton EJ, Jr, Greene FL. Effectiveness of positron emission tomography for the detection of melanoma metastases. Ann Surg. 1998 May;227(5):764–771. [PubMed]
  • Karakousis CP, Velez A, Driscoll DL, Takita H. Metastasectomy in malignant melanoma. Surgery. 1994 Mar;115(3):295–302. [PubMed]
  • Mathisen DJ, Flye MW, Peabody J. The role of thoracotomy in the management of pulmonary metastases from malignant melanoma. Ann Thorac Surg. 1979 Apr;27(4):295–299. [PubMed]
  • Mountain CF, McMurtrey MJ, Hermes KE. Surgery for pulmonary metastasis: a 20-year experience. Ann Thorac Surg. 1984 Oct;38(4):323–330. [PubMed]
  • Ollila DW, Stern SL, Morton DL. Tumor doubling time: a selection factor for pulmonary resection of metastatic melanoma. J Surg Oncol. 1998 Dec;69(4):206–211. [PubMed]
  • Pogrebniak HW, Stovroff M, Roth JA, Pass HI. Resection of pulmonary metastases from malignant melanoma: results of a 16-year experience. Ann Thorac Surg. 1988 Jul;46(1):20–23. [PubMed]
  • Slingluff CL, Jr, Dodge RK, Stanley WE, Seigler HF. The annual risk of melanoma progression. Implications for the concept of cure. Cancer. 1992 Oct 1;70(7):1917–1927. [PubMed]
  • Tafra L, Dale PS, Wanek LA, Ramming KP, Morton DL. Resection and adjuvant immunotherapy for melanoma metastatic to the lung and thorax. J Thorac Cardiovasc Surg. 1995 Jul;110(1):119–129. [PubMed]
  • Thayer JO, Jr, Overholt RH. Metastatic melanoma to the lung: long-term results of surgical excision. Am J Surg. 1985 Apr;149(4):558–562. [PubMed]
  • Wong JH, Skinner KA, Kim KA, Foshag LJ, Morton DL. The role of surgery in the treatment of nonregionally recurrent melanoma. Surgery. 1993 Apr;113(4):389–394. [PubMed]

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