Laparoscopic liver resection for metastatic melanoma

Abstract

Background: Patients with stage IV metastatic melanoma have dismal survival. In the case of liver metastasis, surgical resection may improve survival and represents the only curative modality. Laparoscopic liver resection for metastatic melanoma is poorly studied. Methods: Between April 2000 and August 2013, 11 (1 cutaneous, 9 ocular and 1 unknown primary) patients underwent laparoscopic liver resection for metastases of melanoma at Oslo University Hospital-Rikshospitalet.Perioperative and oncologic outcomes were analyzed. Postoperative morbidity was analyzed by means of Accordion classification. Life tables and Kaplan-Meier method was used for assessment of survival. Median follow-up was 33 (8.5-90) months. Results: Twenty tree liver resections were performed in 11 patients during 13 procedures. Median operative time and blood loss were 137 (65-470) min and <50 (<50-1000) ml, respectively. There were no intraoperative unfavorable incidents and no 30-day mortality in this study.Two patients underwent repeat resection due to developing of new metastases. One-, 3- and 5 year overall survival were 81%, 45% and 9%, respectively. Median overall survival compiled 30 (8.5-91) months. Conclusion: Laparoscopic liver resection melanoma metastases appear to be comparable to those after open resections and may be preferred over open counterpart due to well known advantages. It facilitates potential repeat liver resections in case of resectable liver recurrences.