Surgery Offers Hope for Melanoma Metastasis

Surgical resection may prolong survival in melanoma patients whose cancer has spread to the abdomen

(RxWiki News) In the past, melanoma that metastasized (or spread) to the abdominal organs was considered incurable. Today, surgery may be a promising treatment option.

A new study from the John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, CA, found that surgical resection (an operation to remove the cancerous part of an organ) of melanoma that has spread to the abdomen may help patients live more than twice as long as with chemotherapy alone.

Melanoma is an aggressive type of cancer that develops in cells that produce melanin (the pigment that gives skin its color). While these cancers typically begin as skin cancer, they can also develop in the eyes and internal organs.

Melanomas that have spread to the liver or other abdominal organs have long been considered incurable. However, in the last decade, the availability of immune therapies for advanced melanoma has given doctors treatment options other than chemotherapy.

"Some of these immunotherapy drugs can take a long time to work, however, and may not be effective for everyone," said lead study author Gary B. Deutsch, MD, MPH, a surgical oncologist at North Shore Health System in New York, in a press release. "We have been trying to gauge the role of surgical resection for metastatic melanoma since the development of systemic immunotherapy."

For this study, Dr. Deutsch and team looked at the survival rates of 1,623 patients after a stage IV (metastatic) melanoma diagnosis.

Of these patients, the majority (697) had melanomas that spread to the liver. Other primary sites of spread included the gastrointestinal (GI) tract, adrenal glands, spleen, pancreas and eyes.

All patients who had melanomas that might be operable were referred for surgical evaluation. About 1 in 4 underwent surgical resection of their metastases.

The surgical group’s average survival was found to be 18 months — compared to seven months for the nonsurgical group.

The patients with GI tract melanomas who underwent complete surgical resection survived the longest — more than two years on average.

"Despite new immunotherapies, surgical resection provides the longest survival in patients with abdominal metastatic melanoma," said senior study author Anton J. Bilchik, MD, PhD, a professor of surgery and chief of medicine at the John Wayne Cancer, in a press release. "There is so much excitement about the new systemic immunotherapies, but there needs to continue to be multidisciplinary tumor boards to decide when to intervene surgically."

This study was presented at the 2015 Clinical Congress of the American College of Surgeons. Research presented at conferences may not have been peer-reviewed.

Information on funding sources and conflicts of interest was not available at the time of publication.

Review Date: 
October 19, 2015