• Citer

Surgery of lung, brain and digestive tract melanoma metastases

par Lienard, Danielle ;Sales, François ;Badr-el-Din, A;Pector, Jean Claude ;Lejeune, Ferdinand
Référence Regional cancer treatment, 3, 2, page (79-87)
Publication Publié, 1990

Article révisé par les pairs

• Détails
• Contenu

Résumé :

The authors review the literature and their own experience of surgery for the treatment of melanoma metastases located in the lung, in the brain and in the digestive tract. Criteria for resection of lung metastases include: (a) effective control of the primary, (b) good general condition, (c) resectability and number of metastases, (d) absence of other metastatic sites. The autors' preferred technique has been wedge resection. Long-term survivors have been reported after complete removal, but no prognostic factors seem to be available. At the Bordet institut three of six patients survived longer than 2 years after removal of a mean of 2.8 nodules each. Brain metastases are amenable to neurosurgery and allow long-term survival provided the following criteria are fulfilled: long disease-free intervals, presence of a single metastasis only, and no evidence of extracranial metastases. Severe morbidity with aphasia, hemiparesia and abscess was infrequent and the mortality rate low. Digestive tract melanoma metastases are difficult to diagnose clinically. The authors recommend an aggressive full digestive tract work-up when patients develop any minimal or atypical abdominal symptoms. Bordet's series incudes eight patients. Survivals of more than 14 months were obtained after complete removal of metastases from the stomach, gallbladder, choledochus and small intestine. There seems to be general agreement that the resection of distant metastases is helpful in selected melanoma cases.