Benefits of surgery in advanced melanoma with liver metastasis

The authors evaluated melanoma patients with liver metastasis (spread of cancer from the skin to liver) undergoing surgery or other treatments.  

In advanced melanoma (stage IV), cancer often spreads from the skin to the liver. There are two treatment options in liver metastasis – surgery and systemic therapy (treatment that reaches cells throughout the body). Although there has been considerable advances in systemic therapy, the overall survival (patients who are still alive after treatment) after such therapy still remains poor (between 2-7 months).

With the improvement in surgical techniques over the last decade, surgery is an effective option. It has demonstrated increased survival in melanoma patients with liver metastasis. However, only limited patient data is available on the benefits of surgery and patient follow-up. Data from larger patient populations is needed to understand the effect of surgery in liver metastasis in melanoma. 

The authors aimed to evaluate a large group of melanoma patients with liver metastasis undergoing surgery and/ or systemic therapy.

1,078 melanoma patients with liver metastasis were analyzed in this study. Data was obtained from medical databases over a 20-year period. 5.4% received surgical therapy (group 1). This included surgery and/or ablation (removes damaged tissue using heat).The remaining patients received systemic therapy (group 2).

The median (midpoint) survival was 24.8 months in group 1 and 8 months in group 2. 30% of patients in group 1 and 6.6% of patients in group 2 were still alive after 5 years, following treatment. The 5-year overall survival was 33.3% for patients who underwent ablation plus surgery. It was 28.6% for patients who underwent surgery alone.

In group 1, patients who received incomplete surgical treatment were at a 3.4 times higher risk of dying. There was a 62% reduced risk of death for patients who received systemic therapy before surgery to stabilize (disease status did not improve or decline) the disease.

The authors concluded that surgical treatment significantly increased overall survival in melanoma patients with liver metastasis.