Role of surgery in patients with stage IV melanoma Journal Article
| Authors: | Wong, S. L.; Coit, D. G. |
| Article Title: | Role of surgery in patients with stage IV melanoma |
| Abstract: | Purpose of review: The purpose of this brief review is to highlight recent advances in the surgical treatment of metastatic melanoma; to review factors important in the decision-making process of selecting the most appropriate patients for resection; and to discuss the current literature in the context of site of recurrence. Recent findings: While there are relatively few new findings on the surgical treatment of metastatic melanoma, recent reports do support prior observations in the field. The recently revised staging system for melanoma groups metastatic disease according to prognostic features. There is currently a great deal of interest in the use of 18-fluorodeoxyglucose positron emission tomography (FDG-PET) to more accurately evaluate metastatic disease. The use stereotactic radiosurgery for brain metastases has expanded recently and adds to local treatment options. When procedures are performed with palliative intent, treatment goals must be clearly defined and communicated among the patient, family and surgeon. Improved understanding of the goals of palliative surgery may be facilitated by the concept of a palliative triangle, which helps define the decision making process among the patient, family members, and surgeon. Summary: Metastatic melanoma is usually associated with a dismal prognosis. When a procedure is performed with palliative intent, appropriately selected patients usually experience reliable relief of symptoms and improved quality of life. Improved survival after a complete resection with curative intent is often predicted by good performance status, longer disease-free interval, limited extent of metastatic disease, and less aggressive tumor biology. |
| Keywords: | surgical technique; clinical feature; review; advanced cancer; risk benefit analysis; treatment planning; positron emission tomography; brain neoplasms; lymph node metastasis; neoplasm staging; preoperative evaluation; radiopharmaceuticals; cancer palliative therapy; palliative care; medical decision making; melanoma; metastasis; quality of life; computer assisted tomography; lung neoplasms; risk factors; diagnostic imaging; postoperative complication; gastrointestinal neoplasms; lung metastasis; fluorodeoxyglucose f 18; fluorodeoxyglucose f18; brain metastasis; outcomes research; visceral metastasis; decision making; life expectancy; performance; family; tomography, emission-computed; stereotaxic surgery; palliation; patient; humans; human; priority journal |
| Journal Title: | Current Opinion in Oncology |
| Volume: | 16 |
| Issue: | 2 |
| ISSN: | 1040-8746 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2004-03-01 |
| Start Page: | 155 |
| End Page: | 160 |
| Language: | English |
| DOI: | 10.1097/00001622-200403000-00013 |
| PROVIDER: | scopus |
| PUBMED: | 15075909 |
| DOI/URL: | |
| Notes: | Curr. Opin. Oncol. -- Cited By (since 1996):46 -- Export Date: 16 June 2014 -- CODEN: CUOOE -- Source: Scopus |
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