Clinical outcome after surgical resection of lung metastases from melanoma

Background. Surgical therapy plays an important role in the management of selected patients with metastatic melanoma. Purpose. A retrospective review of 13 patients who underwent surgical resection of lung metastases from melanoma from 1996 to 2003 was performed. The aim of the study was to analyze the clinical outcome and survival time. Materials and methods. Mean age was 45 years old ( range: 31-64). Complete tumour resection was confirmed histologically. Nine patients presented one single pulmonary lesion, two lesions (n = 3) and three lesions ( n = 1) but in all cases confined in the same pulmonary lobe. Results. Median survival time (MST) for the entire group was 20 months (95% confidence interval (CI): 16-24 months). The median time to disease progression after lung metastasectomy was 5 months ( 95% CI: 3-7 months). MST, according to the prognostic groups proposed by the International Registry of Lung Metastases, was 17 months ( 95% CI: 6-28 months) for group I ( n = 6), MST of 20 months ( 95% CI: 16-24 months) for group II ( n = 5) and MST of 4 months for group III ( n = 2), without differences statistically significant (log-rank p = 0.423). MST regarding the time of disease free interval from diagnostic of primary tumour and lung metastases (< 36 months [ n = 5] vs >\ 36 months [ n = 8]) was 20 months and 17 months respectively, without differences statistically significant ( log rank p = 0.222). Conclusions. Surgical resection when feasible provides survival rates superior to any available nonsurgical therapy. In carefully selected patients, when the resection is performed with curative intent, it may result in improved survival.