Surgical Management of Melanoma Lung Metastasis: An Analysis of Survival Outcomes in 292 Consecutive Patients

Background The role of surgical resection of melanoma lung metastases (MLM) remains controversial. Some authorities advocate an aggressive surgical approach, while others recommend a conservative strategy. This study sought to identify the clinicopathologic and predictors of outcome after surgical m...
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Autor*in:	Chua, Terence C. [verfasserIn] Scolyer, Richard A. [verfasserIn] Kennedy, Catherine W. [verfasserIn] Yan, Tristan D. [verfasserIn] McCaughan, Brian C. [verfasserIn] Thompson, John F. [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2012

Schlagwörter:	Melanoma Mediastinal Lymph Node Primary Melanoma Pulmonary Metastasectomy Tumor Doubling Time

Übergeordnetes Werk:	Enthalten in: Annals of surgical oncology - Berlin [u.a.] : Springer, 1994, 19(2012), 6 vom: 31. Jan., Seite 1774-1781
Übergeordnetes Werk:	volume:19 ; year:2012 ; number:6 ; day:31 ; month:01 ; pages:1774-1781

Links:	Volltext

DOI / URN:	10.1245/s10434-011-2197-y

Katalog-ID:	SPR00995080X

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520			\|a Background The role of surgical resection of melanoma lung metastases (MLM) remains controversial. Some authorities advocate an aggressive surgical approach, while others recommend a conservative strategy. This study sought to identify the clinicopathologic and predictors of outcome after surgical management of MLM in a large series of melanoma patients from a single institution. Methods All patients undergoing surgical management of MLM between November 1984 and April 2010 were identified and predictors of outcome analyzed. Results Of the 292 patients eligible for the study, 112 (38%) had previously undergone surgery for nonpulmonary recurrences. Four patients (1%) died within 30 days of surgery for MLM. The median progression-free survival time was 10 months. The median overall survival and 3- and 5-year survival were 23 months [95% confidence interval (CI) 17–30], 41 and 34%, respectively. Metastasis size >2 cm [hazard ratio (HR) 1.4, 95% CI 1.0–1.8, P = 0.03, HR 1.6, 95% CI 1.2–2.2; P = 0.002] and positive surgical margin (HR 1.5, 95% CI 1.2–1.9, P < 0.001; HR 1.4, 95% CI 1.1–1.7, P = 0.003) were independently associated with poorer progression-free survival and overall survival, respectively. The presence of more than one metastasis (HR 1.4, 95% CI 1.1–1.7, P = 0.013) was independently associated with poorer overall survival. Conclusions The results support the role of pulmonary metastasectomy in selected patients with MLM. Patients with small (<2 cm) and solitary tumors that can be completely resected with a negative margin are most likely to experience prolonged survival.
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650		4	\|a Mediastinal Lymph Node \|7 (dpeaa)DE-He213
650		4	\|a Primary Melanoma \|7 (dpeaa)DE-He213
650		4	\|a Pulmonary Metastasectomy \|7 (dpeaa)DE-He213
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700	1		\|a Scolyer, Richard A. \|e verfasserin \|4 aut
700	1		\|a Kennedy, Catherine W. \|e verfasserin \|4 aut
700	1		\|a Yan, Tristan D. \|e verfasserin \|4 aut
700	1		\|a McCaughan, Brian C. \|e verfasserin \|4 aut
700	1		\|a Thompson, John F. \|e verfasserin \|4 aut
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author_variant	t c c tc tcc r a s ra ras c w k cw cwk t d y td tdy b c m bc bcm j f t jf jft
matchkey_str	article:15344681:2012----::ugclaaeetfeaoaugeatssnnlssfuvvlucm
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bklnumber	44.81 44.65
publishDate	2012
allfields	10.1245/s10434-011-2197-y doi (DE-627)SPR00995080X (SPR)s10434-011-2197-y-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Chua, Terence C. verfasserin aut Surgical Management of Melanoma Lung Metastasis: An Analysis of Survival Outcomes in 292 Consecutive Patients 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background The role of surgical resection of melanoma lung metastases (MLM) remains controversial. Some authorities advocate an aggressive surgical approach, while others recommend a conservative strategy. This study sought to identify the clinicopathologic and predictors of outcome after surgical management of MLM in a large series of melanoma patients from a single institution. Methods All patients undergoing surgical management of MLM between November 1984 and April 2010 were identified and predictors of outcome analyzed. Results Of the 292 patients eligible for the study, 112 (38%) had previously undergone surgery for nonpulmonary recurrences. Four patients (1%) died within 30 days of surgery for MLM. The median progression-free survival time was 10 months. The median overall survival and 3- and 5-year survival were 23 months [95% confidence interval (CI) 17–30], 41 and 34%, respectively. Metastasis size >2 cm [hazard ratio (HR) 1.4, 95% CI 1.0–1.8, P = 0.03, HR 1.6, 95% CI 1.2–2.2; P = 0.002] and positive surgical margin (HR 1.5, 95% CI 1.2–1.9, P < 0.001; HR 1.4, 95% CI 1.1–1.7, P = 0.003) were independently associated with poorer progression-free survival and overall survival, respectively. The presence of more than one metastasis (HR 1.4, 95% CI 1.1–1.7, P = 0.013) was independently associated with poorer overall survival. Conclusions The results support the role of pulmonary metastasectomy in selected patients with MLM. Patients with small (<2 cm) and solitary tumors that can be completely resected with a negative margin are most likely to experience prolonged survival. Melanoma (dpeaa)DE-He213 Mediastinal Lymph Node (dpeaa)DE-He213 Primary Melanoma (dpeaa)DE-He213 Pulmonary Metastasectomy (dpeaa)DE-He213 Tumor Doubling Time (dpeaa)DE-He213 Scolyer, Richard A. verfasserin aut Kennedy, Catherine W. verfasserin aut Yan, Tristan D. verfasserin aut McCaughan, Brian C. verfasserin aut Thompson, John F. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 19(2012), 6 vom: 31. Jan., Seite 1774-1781 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:19 year:2012 number:6 day:31 month:01 pages:1774-1781 https://dx.doi.org/10.1245/s10434-011-2197-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 19 2012 6 31 01 1774-1781
spelling	10.1245/s10434-011-2197-y doi (DE-627)SPR00995080X (SPR)s10434-011-2197-y-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Chua, Terence C. verfasserin aut Surgical Management of Melanoma Lung Metastasis: An Analysis of Survival Outcomes in 292 Consecutive Patients 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background The role of surgical resection of melanoma lung metastases (MLM) remains controversial. Some authorities advocate an aggressive surgical approach, while others recommend a conservative strategy. This study sought to identify the clinicopathologic and predictors of outcome after surgical management of MLM in a large series of melanoma patients from a single institution. Methods All patients undergoing surgical management of MLM between November 1984 and April 2010 were identified and predictors of outcome analyzed. Results Of the 292 patients eligible for the study, 112 (38%) had previously undergone surgery for nonpulmonary recurrences. Four patients (1%) died within 30 days of surgery for MLM. The median progression-free survival time was 10 months. The median overall survival and 3- and 5-year survival were 23 months [95% confidence interval (CI) 17–30], 41 and 34%, respectively. Metastasis size >2 cm [hazard ratio (HR) 1.4, 95% CI 1.0–1.8, P = 0.03, HR 1.6, 95% CI 1.2–2.2; P = 0.002] and positive surgical margin (HR 1.5, 95% CI 1.2–1.9, P < 0.001; HR 1.4, 95% CI 1.1–1.7, P = 0.003) were independently associated with poorer progression-free survival and overall survival, respectively. The presence of more than one metastasis (HR 1.4, 95% CI 1.1–1.7, P = 0.013) was independently associated with poorer overall survival. Conclusions The results support the role of pulmonary metastasectomy in selected patients with MLM. Patients with small (<2 cm) and solitary tumors that can be completely resected with a negative margin are most likely to experience prolonged survival. Melanoma (dpeaa)DE-He213 Mediastinal Lymph Node (dpeaa)DE-He213 Primary Melanoma (dpeaa)DE-He213 Pulmonary Metastasectomy (dpeaa)DE-He213 Tumor Doubling Time (dpeaa)DE-He213 Scolyer, Richard A. verfasserin aut Kennedy, Catherine W. verfasserin aut Yan, Tristan D. verfasserin aut McCaughan, Brian C. verfasserin aut Thompson, John F. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 19(2012), 6 vom: 31. Jan., Seite 1774-1781 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:19 year:2012 number:6 day:31 month:01 pages:1774-1781 https://dx.doi.org/10.1245/s10434-011-2197-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 19 2012 6 31 01 1774-1781
allfields_unstemmed	10.1245/s10434-011-2197-y doi (DE-627)SPR00995080X (SPR)s10434-011-2197-y-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Chua, Terence C. verfasserin aut Surgical Management of Melanoma Lung Metastasis: An Analysis of Survival Outcomes in 292 Consecutive Patients 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background The role of surgical resection of melanoma lung metastases (MLM) remains controversial. Some authorities advocate an aggressive surgical approach, while others recommend a conservative strategy. This study sought to identify the clinicopathologic and predictors of outcome after surgical management of MLM in a large series of melanoma patients from a single institution. Methods All patients undergoing surgical management of MLM between November 1984 and April 2010 were identified and predictors of outcome analyzed. Results Of the 292 patients eligible for the study, 112 (38%) had previously undergone surgery for nonpulmonary recurrences. Four patients (1%) died within 30 days of surgery for MLM. The median progression-free survival time was 10 months. The median overall survival and 3- and 5-year survival were 23 months [95% confidence interval (CI) 17–30], 41 and 34%, respectively. Metastasis size >2 cm [hazard ratio (HR) 1.4, 95% CI 1.0–1.8, P = 0.03, HR 1.6, 95% CI 1.2–2.2; P = 0.002] and positive surgical margin (HR 1.5, 95% CI 1.2–1.9, P < 0.001; HR 1.4, 95% CI 1.1–1.7, P = 0.003) were independently associated with poorer progression-free survival and overall survival, respectively. The presence of more than one metastasis (HR 1.4, 95% CI 1.1–1.7, P = 0.013) was independently associated with poorer overall survival. Conclusions The results support the role of pulmonary metastasectomy in selected patients with MLM. Patients with small (<2 cm) and solitary tumors that can be completely resected with a negative margin are most likely to experience prolonged survival. Melanoma (dpeaa)DE-He213 Mediastinal Lymph Node (dpeaa)DE-He213 Primary Melanoma (dpeaa)DE-He213 Pulmonary Metastasectomy (dpeaa)DE-He213 Tumor Doubling Time (dpeaa)DE-He213 Scolyer, Richard A. verfasserin aut Kennedy, Catherine W. verfasserin aut Yan, Tristan D. verfasserin aut McCaughan, Brian C. verfasserin aut Thompson, John F. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 19(2012), 6 vom: 31. Jan., Seite 1774-1781 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:19 year:2012 number:6 day:31 month:01 pages:1774-1781 https://dx.doi.org/10.1245/s10434-011-2197-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 19 2012 6 31 01 1774-1781
allfieldsGer	10.1245/s10434-011-2197-y doi (DE-627)SPR00995080X (SPR)s10434-011-2197-y-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Chua, Terence C. verfasserin aut Surgical Management of Melanoma Lung Metastasis: An Analysis of Survival Outcomes in 292 Consecutive Patients 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background The role of surgical resection of melanoma lung metastases (MLM) remains controversial. Some authorities advocate an aggressive surgical approach, while others recommend a conservative strategy. This study sought to identify the clinicopathologic and predictors of outcome after surgical management of MLM in a large series of melanoma patients from a single institution. Methods All patients undergoing surgical management of MLM between November 1984 and April 2010 were identified and predictors of outcome analyzed. Results Of the 292 patients eligible for the study, 112 (38%) had previously undergone surgery for nonpulmonary recurrences. Four patients (1%) died within 30 days of surgery for MLM. The median progression-free survival time was 10 months. The median overall survival and 3- and 5-year survival were 23 months [95% confidence interval (CI) 17–30], 41 and 34%, respectively. Metastasis size >2 cm [hazard ratio (HR) 1.4, 95% CI 1.0–1.8, P = 0.03, HR 1.6, 95% CI 1.2–2.2; P = 0.002] and positive surgical margin (HR 1.5, 95% CI 1.2–1.9, P < 0.001; HR 1.4, 95% CI 1.1–1.7, P = 0.003) were independently associated with poorer progression-free survival and overall survival, respectively. The presence of more than one metastasis (HR 1.4, 95% CI 1.1–1.7, P = 0.013) was independently associated with poorer overall survival. Conclusions The results support the role of pulmonary metastasectomy in selected patients with MLM. Patients with small (<2 cm) and solitary tumors that can be completely resected with a negative margin are most likely to experience prolonged survival. Melanoma (dpeaa)DE-He213 Mediastinal Lymph Node (dpeaa)DE-He213 Primary Melanoma (dpeaa)DE-He213 Pulmonary Metastasectomy (dpeaa)DE-He213 Tumor Doubling Time (dpeaa)DE-He213 Scolyer, Richard A. verfasserin aut Kennedy, Catherine W. verfasserin aut Yan, Tristan D. verfasserin aut McCaughan, Brian C. verfasserin aut Thompson, John F. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 19(2012), 6 vom: 31. Jan., Seite 1774-1781 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:19 year:2012 number:6 day:31 month:01 pages:1774-1781 https://dx.doi.org/10.1245/s10434-011-2197-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 19 2012 6 31 01 1774-1781
allfieldsSound	10.1245/s10434-011-2197-y doi (DE-627)SPR00995080X (SPR)s10434-011-2197-y-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Chua, Terence C. verfasserin aut Surgical Management of Melanoma Lung Metastasis: An Analysis of Survival Outcomes in 292 Consecutive Patients 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background The role of surgical resection of melanoma lung metastases (MLM) remains controversial. Some authorities advocate an aggressive surgical approach, while others recommend a conservative strategy. This study sought to identify the clinicopathologic and predictors of outcome after surgical management of MLM in a large series of melanoma patients from a single institution. Methods All patients undergoing surgical management of MLM between November 1984 and April 2010 were identified and predictors of outcome analyzed. Results Of the 292 patients eligible for the study, 112 (38%) had previously undergone surgery for nonpulmonary recurrences. Four patients (1%) died within 30 days of surgery for MLM. The median progression-free survival time was 10 months. The median overall survival and 3- and 5-year survival were 23 months [95% confidence interval (CI) 17–30], 41 and 34%, respectively. Metastasis size >2 cm [hazard ratio (HR) 1.4, 95% CI 1.0–1.8, P = 0.03, HR 1.6, 95% CI 1.2–2.2; P = 0.002] and positive surgical margin (HR 1.5, 95% CI 1.2–1.9, P < 0.001; HR 1.4, 95% CI 1.1–1.7, P = 0.003) were independently associated with poorer progression-free survival and overall survival, respectively. The presence of more than one metastasis (HR 1.4, 95% CI 1.1–1.7, P = 0.013) was independently associated with poorer overall survival. Conclusions The results support the role of pulmonary metastasectomy in selected patients with MLM. Patients with small (<2 cm) and solitary tumors that can be completely resected with a negative margin are most likely to experience prolonged survival. Melanoma (dpeaa)DE-He213 Mediastinal Lymph Node (dpeaa)DE-He213 Primary Melanoma (dpeaa)DE-He213 Pulmonary Metastasectomy (dpeaa)DE-He213 Tumor Doubling Time (dpeaa)DE-He213 Scolyer, Richard A. verfasserin aut Kennedy, Catherine W. verfasserin aut Yan, Tristan D. verfasserin aut McCaughan, Brian C. verfasserin aut Thompson, John F. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 19(2012), 6 vom: 31. Jan., Seite 1774-1781 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:19 year:2012 number:6 day:31 month:01 pages:1774-1781 https://dx.doi.org/10.1245/s10434-011-2197-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 19 2012 6 31 01 1774-1781
language	English
source	Enthalten in Annals of surgical oncology 19(2012), 6 vom: 31. Jan., Seite 1774-1781 volume:19 year:2012 number:6 day:31 month:01 pages:1774-1781
sourceStr	Enthalten in Annals of surgical oncology 19(2012), 6 vom: 31. Jan., Seite 1774-1781 volume:19 year:2012 number:6 day:31 month:01 pages:1774-1781
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Melanoma Mediastinal Lymph Node Primary Melanoma Pulmonary Metastasectomy Tumor Doubling Time
dewey-raw	610
isfreeaccess_bool	false
container_title	Annals of surgical oncology
authorswithroles_txt_mv	Chua, Terence C. @@aut@@ Scolyer, Richard A. @@aut@@ Kennedy, Catherine W. @@aut@@ Yan, Tristan D. @@aut@@ McCaughan, Brian C. @@aut@@ Thompson, John F. @@aut@@
publishDateDaySort_date	2012-01-31T00:00:00Z
hierarchy_top_id	343969947
dewey-sort	3610
id	SPR00995080X
language_de	englisch
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Some authorities advocate an aggressive surgical approach, while others recommend a conservative strategy. This study sought to identify the clinicopathologic and predictors of outcome after surgical management of MLM in a large series of melanoma patients from a single institution. Methods All patients undergoing surgical management of MLM between November 1984 and April 2010 were identified and predictors of outcome analyzed. Results Of the 292 patients eligible for the study, 112 (38%) had previously undergone surgery for nonpulmonary recurrences. Four patients (1%) died within 30 days of surgery for MLM. The median progression-free survival time was 10 months. The median overall survival and 3- and 5-year survival were 23 months [95% confidence interval (CI) 17–30], 41 and 34%, respectively. Metastasis size >2 cm [hazard ratio (HR) 1.4, 95% CI 1.0–1.8, P = 0.03, HR 1.6, 95% CI 1.2–2.2; P = 0.002] and positive surgical margin (HR 1.5, 95% CI 1.2–1.9, P < 0.001; HR 1.4, 95% CI 1.1–1.7, P = 0.003) were independently associated with poorer progression-free survival and overall survival, respectively. The presence of more than one metastasis (HR 1.4, 95% CI 1.1–1.7, P = 0.013) was independently associated with poorer overall survival. Conclusions The results support the role of pulmonary metastasectomy in selected patients with MLM. 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author	Chua, Terence C.
spellingShingle	Chua, Terence C. ddc 610 bkl 44.81 bkl 44.65 misc Melanoma misc Mediastinal Lymph Node misc Primary Melanoma misc Pulmonary Metastasectomy misc Tumor Doubling Time Surgical Management of Melanoma Lung Metastasis: An Analysis of Survival Outcomes in 292 Consecutive Patients
authorStr	Chua, Terence C.
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topic_title	610 ASE 44.81 bkl 44.65 bkl Surgical Management of Melanoma Lung Metastasis: An Analysis of Survival Outcomes in 292 Consecutive Patients Melanoma (dpeaa)DE-He213 Mediastinal Lymph Node (dpeaa)DE-He213 Primary Melanoma (dpeaa)DE-He213 Pulmonary Metastasectomy (dpeaa)DE-He213 Tumor Doubling Time (dpeaa)DE-He213
topic	ddc 610 bkl 44.81 bkl 44.65 misc Melanoma misc Mediastinal Lymph Node misc Primary Melanoma misc Pulmonary Metastasectomy misc Tumor Doubling Time
topic_unstemmed	ddc 610 bkl 44.81 bkl 44.65 misc Melanoma misc Mediastinal Lymph Node misc Primary Melanoma misc Pulmonary Metastasectomy misc Tumor Doubling Time
topic_browse	ddc 610 bkl 44.81 bkl 44.65 misc Melanoma misc Mediastinal Lymph Node misc Primary Melanoma misc Pulmonary Metastasectomy misc Tumor Doubling Time
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title	Surgical Management of Melanoma Lung Metastasis: An Analysis of Survival Outcomes in 292 Consecutive Patients
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title_full	Surgical Management of Melanoma Lung Metastasis: An Analysis of Survival Outcomes in 292 Consecutive Patients
author_sort	Chua, Terence C.
journal	Annals of surgical oncology
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author_browse	Chua, Terence C. Scolyer, Richard A. Kennedy, Catherine W. Yan, Tristan D. McCaughan, Brian C. Thompson, John F.
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author-letter	Chua, Terence C.
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title_sort	surgical management of melanoma lung metastasis: an analysis of survival outcomes in 292 consecutive patients
title_auth	Surgical Management of Melanoma Lung Metastasis: An Analysis of Survival Outcomes in 292 Consecutive Patients
abstract	Background The role of surgical resection of melanoma lung metastases (MLM) remains controversial. Some authorities advocate an aggressive surgical approach, while others recommend a conservative strategy. This study sought to identify the clinicopathologic and predictors of outcome after surgical management of MLM in a large series of melanoma patients from a single institution. Methods All patients undergoing surgical management of MLM between November 1984 and April 2010 were identified and predictors of outcome analyzed. Results Of the 292 patients eligible for the study, 112 (38%) had previously undergone surgery for nonpulmonary recurrences. Four patients (1%) died within 30 days of surgery for MLM. The median progression-free survival time was 10 months. The median overall survival and 3- and 5-year survival were 23 months [95% confidence interval (CI) 17–30], 41 and 34%, respectively. Metastasis size >2 cm [hazard ratio (HR) 1.4, 95% CI 1.0–1.8, P = 0.03, HR 1.6, 95% CI 1.2–2.2; P = 0.002] and positive surgical margin (HR 1.5, 95% CI 1.2–1.9, P < 0.001; HR 1.4, 95% CI 1.1–1.7, P = 0.003) were independently associated with poorer progression-free survival and overall survival, respectively. The presence of more than one metastasis (HR 1.4, 95% CI 1.1–1.7, P = 0.013) was independently associated with poorer overall survival. Conclusions The results support the role of pulmonary metastasectomy in selected patients with MLM. Patients with small (<2 cm) and solitary tumors that can be completely resected with a negative margin are most likely to experience prolonged survival.
abstractGer	Background The role of surgical resection of melanoma lung metastases (MLM) remains controversial. Some authorities advocate an aggressive surgical approach, while others recommend a conservative strategy. This study sought to identify the clinicopathologic and predictors of outcome after surgical management of MLM in a large series of melanoma patients from a single institution. Methods All patients undergoing surgical management of MLM between November 1984 and April 2010 were identified and predictors of outcome analyzed. Results Of the 292 patients eligible for the study, 112 (38%) had previously undergone surgery for nonpulmonary recurrences. Four patients (1%) died within 30 days of surgery for MLM. The median progression-free survival time was 10 months. The median overall survival and 3- and 5-year survival were 23 months [95% confidence interval (CI) 17–30], 41 and 34%, respectively. Metastasis size >2 cm [hazard ratio (HR) 1.4, 95% CI 1.0–1.8, P = 0.03, HR 1.6, 95% CI 1.2–2.2; P = 0.002] and positive surgical margin (HR 1.5, 95% CI 1.2–1.9, P < 0.001; HR 1.4, 95% CI 1.1–1.7, P = 0.003) were independently associated with poorer progression-free survival and overall survival, respectively. The presence of more than one metastasis (HR 1.4, 95% CI 1.1–1.7, P = 0.013) was independently associated with poorer overall survival. Conclusions The results support the role of pulmonary metastasectomy in selected patients with MLM. Patients with small (<2 cm) and solitary tumors that can be completely resected with a negative margin are most likely to experience prolonged survival.
abstract_unstemmed	Background The role of surgical resection of melanoma lung metastases (MLM) remains controversial. Some authorities advocate an aggressive surgical approach, while others recommend a conservative strategy. This study sought to identify the clinicopathologic and predictors of outcome after surgical management of MLM in a large series of melanoma patients from a single institution. Methods All patients undergoing surgical management of MLM between November 1984 and April 2010 were identified and predictors of outcome analyzed. Results Of the 292 patients eligible for the study, 112 (38%) had previously undergone surgery for nonpulmonary recurrences. Four patients (1%) died within 30 days of surgery for MLM. The median progression-free survival time was 10 months. The median overall survival and 3- and 5-year survival were 23 months [95% confidence interval (CI) 17–30], 41 and 34%, respectively. Metastasis size >2 cm [hazard ratio (HR) 1.4, 95% CI 1.0–1.8, P = 0.03, HR 1.6, 95% CI 1.2–2.2; P = 0.002] and positive surgical margin (HR 1.5, 95% CI 1.2–1.9, P < 0.001; HR 1.4, 95% CI 1.1–1.7, P = 0.003) were independently associated with poorer progression-free survival and overall survival, respectively. The presence of more than one metastasis (HR 1.4, 95% CI 1.1–1.7, P = 0.013) was independently associated with poorer overall survival. Conclusions The results support the role of pulmonary metastasectomy in selected patients with MLM. Patients with small (<2 cm) and solitary tumors that can be completely resected with a negative margin are most likely to experience prolonged survival.
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container_issue	6
title_short	Surgical Management of Melanoma Lung Metastasis: An Analysis of Survival Outcomes in 292 Consecutive Patients
url	https://dx.doi.org/10.1245/s10434-011-2197-y
remote_bool	true
author2	Scolyer, Richard A. Kennedy, Catherine W. Yan, Tristan D. McCaughan, Brian C. Thompson, John F.
author2Str	Scolyer, Richard A. Kennedy, Catherine W. Yan, Tristan D. McCaughan, Brian C. Thompson, John F.
ppnlink	343969947
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doi_str	10.1245/s10434-011-2197-y
up_date	2024-07-04T03:38:41.554Z
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