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Hepatic Resection for Metastatic Melanoma: Distinct Patterns of Recurrence and Prognosis for Ocular Versus Cutaneous Disease

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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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Authors and Affiliations

  1. Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 444, Houston, Texas, 77030

    Timothy M. Pawlik MD, MPH, Daria Zorzi MD, Eddie K. Abdalla MD, Jeffrey E. Gershenwald MD, Merrick I. Ross MD, Thomas A. Aloia MD, Steven A. Curley MD & Jean-Nicolas Vauthey MD

  2. Department of Melanoma Medical Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 422, Houston, Texas, 77030

    Luis H. Camacho MD, MPH

  3. Department of Surgery, Duke University Medical Center, Trent Drive, Box 3247, Durham, North Carolina, 27710

    Bryan M. Clary MD

  4. Unit of Surgical Oncology, Institute for Research and the Cure of Cancer, Strada Provinciale 142, Km. 3.95, Candiolo, 10060, Italy

    Lorenzo Capussotti MD

  5. Department of Surgery, Gustave Roussy Institute, 39 Rue Camille Desmoulins, Villejuif Cedex, 94805, France

    Dominique Elias MD

Authors
  1. Timothy M. Pawlik MD, MPH
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  2. Daria Zorzi MD
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  12. Jean-Nicolas Vauthey MD
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Correspondence to Jean-Nicolas Vauthey MD.

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Pawlik, T.M., Zorzi, D., Abdalla, E.K. et al. Hepatic Resection for Metastatic Melanoma: Distinct Patterns of Recurrence and Prognosis for Ocular Versus Cutaneous Disease. Ann Surg Oncol 13, 712–720 (2006). https://doi.org/10.1245/ASO.2006.01.016

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  • DOI: https://doi.org/10.1245/ASO.2006.01.016

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