Hepatic resection for metastatic melanoma in The Netherlands: survival and prognostic factors. 2013

Jannemarie de Ridder, and Marlies van Walsum, and Cornelis Verhoef, and Iris Nagtegaal, and Johannes de Wilt, and
Department of aSurgical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. jannemarie@hotmail.com

Patients with hepatic metastases of melanoma have a very poor prognosis, with a median overall survival of less than 6 months. There are several small heterogeneous studies that have shown an association with prolonged survival in those patients treated with hepatic resection, but the role of surgery remains unclear. We evaluated the safety and efficacy of hepatic resection in a population-based study in the Netherlands for patients with metastatic melanoma and assessed the factors that could affect disease-free and overall survival. Patients with hepatic melanoma metastases who underwent potentially curative resection were identified between 1994 until 2010 using the PALGA database, a nation-wide network and registry of histopathology and cytopathology in the Netherlands. They were retrospectively evaluated for clinical and pathological factors with respect to recurrence and survival using Kaplan-Meier curves to assess survival and univariate regression analysis for the assessment of potential prognostic factors. A total of 32 patients were identified in 15 hospitals, 19 men and 13 women. The median age of the patients at the time of hepatic resection was 52 years (range 27-69). Postoperative complications occurred in five patients (15%), without postoperative mortality. The median follow-up was 21 months (range 3-65). The median disease-free survival was 11 months (range 0-57) and the median overall survival was 29 months (range 4-66). Significant prognostic factors for overall survival in univariate analysis were the distribution and number of metastases, as well as the type of hepatic resection (major or minor). Hepatic resection in patients with resectable metastatic melanoma is safe and might be associated with a prolonged survival in a highly selected group of patients.

UI MeSH Term Description Entries
D008113 Liver Neoplasms Tumors or cancer of the LIVER. Cancer of Liver,Hepatic Cancer,Liver Cancer,Cancer of the Liver,Cancer, Hepatocellular,Hepatic Neoplasms,Hepatocellular Cancer,Neoplasms, Hepatic,Neoplasms, Liver,Cancer, Hepatic,Cancer, Liver,Cancers, Hepatic,Cancers, Hepatocellular,Cancers, Liver,Hepatic Cancers,Hepatic Neoplasm,Hepatocellular Cancers,Liver Cancers,Liver Neoplasm,Neoplasm, Hepatic,Neoplasm, Liver
D008297 Male Males
D008545 Melanoma A malignant neoplasm derived from cells that are capable of forming melanin, which may occur in the skin of any part of the body, in the eye, or, rarely, in the mucous membranes of the genitalia, anus, oral cavity, or other sites. It occurs mostly in adults and may originate de novo or from a pigmented nevus or malignant lentigo. Melanomas frequently metastasize widely, and the regional lymph nodes, liver, lungs, and brain are likely to be involved. The incidence of malignant skin melanomas is rising rapidly in all parts of the world. (Stedman, 25th ed; from Rook et al., Textbook of Dermatology, 4th ed, p2445) Malignant Melanoma,Malignant Melanomas,Melanoma, Malignant,Melanomas,Melanomas, Malignant
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009426 Netherlands Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, and Sint Maarten, formerly included in the NETHERLANDS ANTILLES. Holland,Kingdom of the Netherlands
D005260 Female Females
D006498 Hepatectomy Excision of all or part of the liver. (Dorland, 28th ed) Hepatectomies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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