Survival after Pulmonary Metastasectomy in Patients with Malignant Melanoma

Background: Surgical resection is an important interdisciplinary treatment for pulmonary metastases of metastatic malignant melanoma. The purpose of this study was to determine the clinical course, outcome and prognostic factors in a subset of patients recently treated by metastasectomy. Material and Methods: Between 1995 and 2007, 30 patients (19 men, 11 women) with pulmonary metastases from malignant melanoma underwent pulmonary resection. Exclusion of primary tumor recurrence and other extrapulmonary metastases was mandatory for inclusion in the study. The median follow-up was 93.7 months. These patients' records were subsequently reviewed. Results: Cumulative 5-year survival rate after pulmonary resection was 35.1% with a median survival of 18.3 months. Complete pulmonary re-section was achieved in 27 patients who had a median survival of 20.5 months compared to 13.0 months after incomplete resection; however, completeness of resection was not a statistically prognostic factor for survival. Multivariate analysis identified gender as the only significant prognostic parameter for overall survival in the group of patients after complete resection of pulmonary metastases, with 9.4 months versus 25.0 months for the female and male group, respectively (p = 0.022). Conclusions: We conclude that pulmonary metastasectomy for metastases of malignant melanoma is a safe treatment modality which may actually be of benefit in selected patients with stage IV malignant melanoma. When pulmonary metastases of malignant melanoma are present, every attempt should be made to completely resect all clinically detected metastases.