Role of Surgery in Stage IV Melanoma

Conor H O'Neill; Kelly M McMasters; Michael E Egger

doi:10.1016/j.soc.2020.02.010

Role of Surgery in Stage IV Melanoma

Surg Oncol Clin N Am. 2020 Jul;29(3):485-495. doi: 10.1016/j.soc.2020.02.010.

Authors

Conor H O'Neill¹, Kelly M McMasters¹, Michael E Egger²

Affiliations

¹ The Hiram C. Polk Jr., MD, Department of Surgery, University of Louisville, 315 East Broadway, M-10, Louisville, KY 40202, USA.
² The Hiram C. Polk Jr., MD, Department of Surgery, University of Louisville, 315 East Broadway, M-10, Louisville, KY 40202, USA. Electronic address: michael.egger@louisville.edu.

PMID: 32482322
DOI: 10.1016/j.soc.2020.02.010

Abstract

Stage IV melanoma has a 5-year survival rate of 6%, but considerable advances have been made in systemic therapies. Systemic immunotherapy has achieved durable responses in up to 40% of patients, with similar improvements with targeted therapies. This has reshaped the landscape for surgery in stage IV melanoma. Metastasectomy can be considered in patients on systemic immunotherapy or targeted therapy with responding, stable, or isolated progressing lesions, oligometastatic disease, or long disease-free intervals. Surgery plays a role in providing tumor tissue for preparation of tumor-infiltrating lymphocytes for adoptive cell therapy. Surgical palliation plays a role in patients with symptomatic metastases.

Keywords: Cutaneous malignancy; Melanoma; Metastasectomy; Metastatic melanoma; Stage IV melanoma.

Publication types

Review

MeSH terms

Humans
Melanoma / pathology
Melanoma / surgery*
Metastasectomy / methods*
Neoplasm Staging
Skin Neoplasms / secondary
Skin Neoplasms / surgery*