Hepatic resection for metastatic melanoma

Distinct patterns of recurrence and prognosis for ocular versus cutaneous disease

Timothy M. Pawlik, Daria Zorzi, Eddie K. Abdalla, Bryan M. Clary, Jeffrey E. Gershenwald, Merrick I. Ross, Thomas A. Aloia, Steven A. Curley, Luis H. Camacho, Lorenzo Capussotti, Dominique Elias, Jean Nicolas Vauthey

Research output: Contribution to journalArticle

Abstract

Background: Resection of melanoma metastatic to the liver remains controversial. We evaluated the efficacy of hepatic resection in patients with metastatic ocular and cutaneous melanoma and assessed factors that could affect survival after resection. Methods: Forty patients with hepatic melanoma metastasis underwent resection at four major hepatobiliary centers. Clinicopathologic factors were evaluated with regard to recurrence and survival by using χ2 and log-rank tests. Results: The primary tumor was ocular in 16 patients and cutaneous in 24. The median disease-free interval from the time of primary tumor treatment to hepatic metastasis was the same for both groups (ocular, 62.9 months; cutaneous, 63.1 months; P = .94). Most patients underwent either an extended hepatic resection (37.5%) or hemihepatectomy (22.5%). Twenty-six patients (65%) received perioperative systemic therapy. Thirty (75.0%) of 40 patients developed tumor recurrence. The median time to recurrence after hepatic resection was 8.3 months (ocular, 8.8 months; cutaneous, 4.7 months; P = .3). Patients with primary ocular melanoma were more likely to experience recurrence within the liver (53.3% vs. 17.4%; P = .015), whereas patients with a cutaneous primary tumor more often developed extrahepatic involvement. The 5-year survival rate for patients with a primary ocular melanoma was 20.5%, whereas there were no 5-year survivors for patients with cutaneous melanoma (P = .03). Conclusions: Patterns of recurrence and prognosis after resection of hepatic melanoma metastasis differ depending on whether the primary melanoma is ocular or cutaneous. Resection should be performed as part of a multidisciplinary approach, because recurrence is common.

Original languageEnglish (US)
Pages (from-to)712-720
Number of pages9
JournalAnnals of Surgical Oncology
Volume13
Issue number5
DOIs
StatePublished - May 2006
Externally publishedYes

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Skin Diseases
Melanoma
Recurrence
Liver
Skin
Neoplasm Metastasis
Neoplasms
Survival
Survivors
Survival Rate
Therapeutics

Keywords

  • Cutaneous
  • Liver
  • Melanoma
  • Ocular
  • Outcome
  • Resection

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Pawlik, T. M., Zorzi, D., Abdalla, E. K., Clary, B. M., Gershenwald, J. E., Ross, M. I., ... Vauthey, J. N. (2006). Hepatic resection for metastatic melanoma: Distinct patterns of recurrence and prognosis for ocular versus cutaneous disease. Annals of Surgical Oncology, 13(5), 712-720. https://doi.org/10.1245/ASO.2006.01.016

Hepatic resection for metastatic melanoma : Distinct patterns of recurrence and prognosis for ocular versus cutaneous disease. / Pawlik, Timothy M.; Zorzi, Daria; Abdalla, Eddie K.; Clary, Bryan M.; Gershenwald, Jeffrey E.; Ross, Merrick I.; Aloia, Thomas A.; Curley, Steven A.; Camacho, Luis H.; Capussotti, Lorenzo; Elias, Dominique; Vauthey, Jean Nicolas.

In: Annals of Surgical Oncology, Vol. 13, No. 5, 05.2006, p. 712-720.

Research output: Contribution to journalArticle

Pawlik, TM, Zorzi, D, Abdalla, EK, Clary, BM, Gershenwald, JE, Ross, MI, Aloia, TA, Curley, SA, Camacho, LH, Capussotti, L, Elias, D & Vauthey, JN 2006, 'Hepatic resection for metastatic melanoma: Distinct patterns of recurrence and prognosis for ocular versus cutaneous disease', Annals of Surgical Oncology, vol. 13, no. 5, pp. 712-720. https://doi.org/10.1245/ASO.2006.01.016
Pawlik, Timothy M. ; Zorzi, Daria ; Abdalla, Eddie K. ; Clary, Bryan M. ; Gershenwald, Jeffrey E. ; Ross, Merrick I. ; Aloia, Thomas A. ; Curley, Steven A. ; Camacho, Luis H. ; Capussotti, Lorenzo ; Elias, Dominique ; Vauthey, Jean Nicolas. / Hepatic resection for metastatic melanoma : Distinct patterns of recurrence and prognosis for ocular versus cutaneous disease. In: Annals of Surgical Oncology. 2006 ; Vol. 13, No. 5. pp. 712-720.
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abstract = "Background: Resection of melanoma metastatic to the liver remains controversial. We evaluated the efficacy of hepatic resection in patients with metastatic ocular and cutaneous melanoma and assessed factors that could affect survival after resection. Methods: Forty patients with hepatic melanoma metastasis underwent resection at four major hepatobiliary centers. Clinicopathologic factors were evaluated with regard to recurrence and survival by using χ2 and log-rank tests. Results: The primary tumor was ocular in 16 patients and cutaneous in 24. The median disease-free interval from the time of primary tumor treatment to hepatic metastasis was the same for both groups (ocular, 62.9 months; cutaneous, 63.1 months; P = .94). Most patients underwent either an extended hepatic resection (37.5{\%}) or hemihepatectomy (22.5{\%}). Twenty-six patients (65{\%}) received perioperative systemic therapy. Thirty (75.0{\%}) of 40 patients developed tumor recurrence. The median time to recurrence after hepatic resection was 8.3 months (ocular, 8.8 months; cutaneous, 4.7 months; P = .3). Patients with primary ocular melanoma were more likely to experience recurrence within the liver (53.3{\%} vs. 17.4{\%}; P = .015), whereas patients with a cutaneous primary tumor more often developed extrahepatic involvement. The 5-year survival rate for patients with a primary ocular melanoma was 20.5{\%}, whereas there were no 5-year survivors for patients with cutaneous melanoma (P = .03). Conclusions: Patterns of recurrence and prognosis after resection of hepatic melanoma metastasis differ depending on whether the primary melanoma is ocular or cutaneous. Resection should be performed as part of a multidisciplinary approach, because recurrence is common.",
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T2 - Distinct patterns of recurrence and prognosis for ocular versus cutaneous disease

AU - Pawlik, Timothy M.

AU - Zorzi, Daria

AU - Abdalla, Eddie K.

AU - Clary, Bryan M.

AU - Gershenwald, Jeffrey E.

AU - Ross, Merrick I.

AU - Aloia, Thomas A.

AU - Curley, Steven A.

AU - Camacho, Luis H.

AU - Capussotti, Lorenzo

AU - Elias, Dominique

AU - Vauthey, Jean Nicolas

PY - 2006/5

Y1 - 2006/5

N2 - Background: Resection of melanoma metastatic to the liver remains controversial. We evaluated the efficacy of hepatic resection in patients with metastatic ocular and cutaneous melanoma and assessed factors that could affect survival after resection. Methods: Forty patients with hepatic melanoma metastasis underwent resection at four major hepatobiliary centers. Clinicopathologic factors were evaluated with regard to recurrence and survival by using χ2 and log-rank tests. Results: The primary tumor was ocular in 16 patients and cutaneous in 24. The median disease-free interval from the time of primary tumor treatment to hepatic metastasis was the same for both groups (ocular, 62.9 months; cutaneous, 63.1 months; P = .94). Most patients underwent either an extended hepatic resection (37.5%) or hemihepatectomy (22.5%). Twenty-six patients (65%) received perioperative systemic therapy. Thirty (75.0%) of 40 patients developed tumor recurrence. The median time to recurrence after hepatic resection was 8.3 months (ocular, 8.8 months; cutaneous, 4.7 months; P = .3). Patients with primary ocular melanoma were more likely to experience recurrence within the liver (53.3% vs. 17.4%; P = .015), whereas patients with a cutaneous primary tumor more often developed extrahepatic involvement. The 5-year survival rate for patients with a primary ocular melanoma was 20.5%, whereas there were no 5-year survivors for patients with cutaneous melanoma (P = .03). Conclusions: Patterns of recurrence and prognosis after resection of hepatic melanoma metastasis differ depending on whether the primary melanoma is ocular or cutaneous. Resection should be performed as part of a multidisciplinary approach, because recurrence is common.

AB - Background: Resection of melanoma metastatic to the liver remains controversial. We evaluated the efficacy of hepatic resection in patients with metastatic ocular and cutaneous melanoma and assessed factors that could affect survival after resection. Methods: Forty patients with hepatic melanoma metastasis underwent resection at four major hepatobiliary centers. Clinicopathologic factors were evaluated with regard to recurrence and survival by using χ2 and log-rank tests. Results: The primary tumor was ocular in 16 patients and cutaneous in 24. The median disease-free interval from the time of primary tumor treatment to hepatic metastasis was the same for both groups (ocular, 62.9 months; cutaneous, 63.1 months; P = .94). Most patients underwent either an extended hepatic resection (37.5%) or hemihepatectomy (22.5%). Twenty-six patients (65%) received perioperative systemic therapy. Thirty (75.0%) of 40 patients developed tumor recurrence. The median time to recurrence after hepatic resection was 8.3 months (ocular, 8.8 months; cutaneous, 4.7 months; P = .3). Patients with primary ocular melanoma were more likely to experience recurrence within the liver (53.3% vs. 17.4%; P = .015), whereas patients with a cutaneous primary tumor more often developed extrahepatic involvement. The 5-year survival rate for patients with a primary ocular melanoma was 20.5%, whereas there were no 5-year survivors for patients with cutaneous melanoma (P = .03). Conclusions: Patterns of recurrence and prognosis after resection of hepatic melanoma metastasis differ depending on whether the primary melanoma is ocular or cutaneous. Resection should be performed as part of a multidisciplinary approach, because recurrence is common.

KW - Cutaneous

KW - Liver

KW - Melanoma

KW - Ocular

KW - Outcome

KW - Resection

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