Background: Pulmonary metastasectomy is a now well-established operation performed routinely with the aim of improving survival. Much advancement has been made with the diagnostic and therapeutic strategies for the treatment of metastatic melanoma. Few case series demonstrate the outcomes of this contemporary approach.Methods: We present a retrospective clinical study of our experience at the Peter MacCallum Cancer. Kaplan-Meier curves were used to describe overall survival. An exact log rank test was used to compare the curves for each possible risk factor.Results: Thirty-one patients (22 males, nine females) undergoing this procedure between August 2002 and December 2010 were identified. Ages ranged from 22 to 84 (median 62) years. Follow-up ranged from three months to eight years (median 18 months). 11 deaths were recorded. Time to pulmonary metastasis ranged from two months to 15 years (median 26 months). More than one pulmonary metastasis was identified as a significant risk factor (HR 4.29 [1.17 – 15.77], p = 0.011). Age >=60 years (HR 5.7 [0.24 – 2.50], p = 0.764), male gender (HR 1.16 [0.52 – 6.90], p = 0.523), wedge resection (HR 0.96 [0.23 – 3.54], p = 1), time to pulmonary metastasis >=36 months (HR 1.06 [0.34 – 3.68], p = 1) and tumour size (HR 1.01 [0.95 – 1.08], p = 0.815) were not shown to be statistically significant predictors of mortality.Conclusions: Improvements in the diagnosis of metastatic disease through novel imaging techniques, changes in the criteria for patient selection and modifications of strategies for adjuvant systemic treatment continue to refine and improve our outcomes.
|Publication status||Published - 27 Apr 2011|
- Cancer Surgery