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Surgical Treatment For Melanoma Liver Metastases Increases Survival

Source: Clinical Oncology, July 2014

While surgery for liver metastases historically has not been considered a treatment option for most patients, a new study has shown that use of advanced surgical techniques along with novel systemic therapies can improve survival among patients whose disease is isolated to a few areas in the liver.

During the study, researchers reviewed the medical records of 1,078 patients who had been treated for melanoma liver metastases since 1991 (J Am Coll Surg. 2014;219(1):62-68). Of those, 58 were treated surgically with liver resection, and in some cases treatment included local ablation therapy in addition to resection.
Average overall survival among patients who underwent surgical resection was more than triple that among patients who received medical therapy without surgical treatment (24.8 months vs. eight months). Additionally, the five-year survival rate for surgical patients was 30%, compared with 6.6% for the nonsurgical group.
The investigators also looked at the relationship between systemic therapy and surgical treatment. According to the authors, patients whose metastatic disease had been stabilized with systemic therapy prior to the operation did much better over the long term than those whose disease had not been stabilized prior to surgery.
What holds promise for the future is the possibility of combining systemic therapy with local surgical or ablative therapies, according to lead investigator Mark Faries, MD, FACS, the director of the John Wayne Cancer Institute’s Donald L. Morton, MD, Melanoma Research Program, in Santa Monica, Calif.
“This approach could apply to liver metastases as well as metastases in other places in the body,” noted Dr. Faries in a press release. “That path would give surgeons the opportunity to more appropriately select patients for surgical treatment and to assess their response to the new drugs.”


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