Surgical treatment for abdominal melanoma metastases

This study evaluated the effectiveness of surgery to remove abdominal melanoma metastatic lesions. In addition, the study proposes a new method of predicting surgery outcomes.

Melanoma is a type of malignant skin cancer which has a high tendency to metastasize (spread into distant organs). While patients with intra-abdominal metastasis are usually not candidates for surgical treatment, some studies have suggested that certain patients may benefit from surgical removal of these metastatic lesions.

The study included 44 patients who underwent surgery to remove intra-abdominal metastatic melanoma lesions.  The intent of surgery was ordered according to the following categories: curative (intended to achieve complete clearance of all cancer cells); cytoreductive intent (partial removal of a lesion that cannot be completely excised); and palliative treatment (intended to relieve symptoms or complications in patients with an otherwise inoperable cancer).

Results showed that complete resection of abdominal melanoma lesions was achieved in 43% of patients operated on. In the majority of cases in which complete resection was achieved, metastatic lesions were apparent in less than 3 abdominal sites. Among patients undergoing surgery with curative intent, the 5-year overall survival rate was 44 %. 5-year overall survival rate was 9% among patients undergoing surgery with cytoreductive intent, and 0% among patients undergoing surgery with palliative intent. The study suggested the use of neutrophil to lymphocyte ratio (NLR) as a predictor of surgery efficiency (neutrophils and lymphocytes are types of white blood cells). It was found that patients with a NLR lower than 5 experienced significantly prolonged overall survival compared to patients with a NLR higher than 5.

This study suggest that surgical resection of intra-abdominal metastases from melanoma may be appropriate for some patients. Neutrophil to lymphocyte ratio may be an important predictor of prognosis and can be useful in patient selection.

This study included only a limited number of patients. Further trials including larger samples are required to determine the importance of NLR as an accurate prognostic factor.