Surgery for Melanoma That Has Spread May Extend Life

Melanoma that has reached the liver may be treatable with surgery

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) People with a type of skin cancer that has spread to the liver may live only four to five months, but doctors may be able to extend that time frame for some patients.

People who have melanoma that has spread to limited parts of the liver may add months to their life through surgery to remove these metastases, according to a new study.

"Ask an oncologist if surgery is the right option for you."

Mark Faries, MD, of the John Wayne Cancer Institute in Santa Monica, California, led this study.

The investigators studied medical records of 1,078 patients treated for metastatic melanoma to the liver (skin cancer that has spread to the liver) at their center from 1991 to 2010. Fifty-eight patients were treated with a liver resection (surgical removal of part of the liver) and in some cases also underwent ablation (a way to use heat to destroy the tumor without removing it).

Four patients had surgery that was meant to make them more comfortable but not to cure them, leaving 1,016 patients who received medicine to treat their cancer but no surgery.

The mid-range time of survival for people who had surgery was 24.8 months, and the mid-range survival time for those who did not have surgery eight months, the researchers found.

Furthermore, the five-year survival rate for those who had surgery was 30 percent, but only 6.6 percent for people who had medical treatment but no surgery.

Not everyone whose melanoma has spread to the liver is a candidate for surgery, the authors noted. Surgery is typically recommended in people whose cancer is localized. Ablation is also dependent on the extent of the disease, or how many other chronic illnesses the patient has.

Only about one patient with melanoma in the liver out of 20 is a candidate for surgery, Dr. Faries noted. “What we have seen in previous studies is that many patients who are able to undergo resection of their metastatic disease from melanoma can have good long-term outcomes, which is important to remember even in an era of more effective medications,” he said in a press release.

The researchers also found that patients who received medications that shrank their tumor or slowed its growth could also have surgery, and lived longer as a result.

Brian Lawenda, MD, National Director of Integrative Oncology and Cancer Survivorship at 21st Century Oncology in Las Vegas, Nevada, did not find the results of this study surprising.

"This large retrospective analysis confirms what most oncologists who specialize in melanoma already know, which is that surgical or ablative therapies used for liver metastases may improve survival outcomes in highly selected patients who are in good health, have had a good response to systemic therapies [such as medication for the whole body] and only have a limited extent of metastatic disease (i.e. 1-3 lesions)," Dr. Lawenda told dailyRx News.

Unfortunately, there are many patients whose cancer is now in their liver who cannot benefit, he added. “Although the media headlines of this paper will likely tout the statistical benefits for those who undergo partial liver resections and/or ablation procedures for metastatic melanoma, it needs to be emphasized (and the authors were careful to do so) that these higher survival rates will certainly not apply for the vast majority of patients with less favorable characteristics," he said.

This study appears in the July issue of the Journal of the American College of Surgeons.

The study authors did not disclose any conflicts of interest.

Review Date: 
July 2, 2014
Last Updated:
July 3, 2014