Long-Term Survival After Complete Resection of Melanoma Metastatic to the Adrenal Gland

Haigh, Philip I.; Essner, Richard; Wardlaw, James C.; Stern, Stacey L.; Morton, Donald L.

doi:10.1007/s10434-999-0633-z

Cited by 64 publications

(41 citation statements)

References 27 publications

(32 reference statements)

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“…[29][30][31][32] Patients with resectable distant disease represent a small proportion of patients with stage IV melanoma and are more likely to have early-detected, isolated, or small in size and number of metastases. [30][31][32] Since the early 1990s the screening for metastasis in our institution was performed according to the guidelines of the German Society of Dermatology, which suggested intense follow-up examinations including imaging techniques with the routine use of lymph node ultrasound. 33 This follow-up strategy was recently evaluated in our institution and yielded a high proportion of detection of metastasis by the physicians carrying out the follow-up examinations.…”

Section: Discussionmentioning

confidence: 99%

Improvement of overall survival of patients with cutaneous melanoma in Germany, 1976–2001

Lasithiotakis

Leiter

Eigentler

et al. 2007

Cancer

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BACKGROUND.A hypothesis generated a retrospective analysis of the improvement of survival over time in patients with cutaneous melanoma (CM) in order to identify factors contributing to this progress.METHODS.A cohort of 4791 patients diagnosed with primary CM in southern Germany between 1976 and 2001 was analyzed. Kaplan‐Meier analyses were performed to estimate and to compare overall survival (OS) and survival after first recurrence (SAR). The Cox proportional hazards model was used to evaluate the effect of multiple variables on OS and SAR.RESULTS.Diagnosis of primary CM during 1990–2001 compared with 1976–1989 was associated with more favorable 10‐year OS (88.6% vs 80.0%, P < .0001). The median tumor thickness at primary diagnosis was significantly lower during the second period (0.75 mm vs 1.07 mm, P < .0001). In the multivariate analysis, adjusted for tumor thickness, ulceration, age, gender, and anatomical site, the period of diagnosis retained its significance as a predictor of OS (P = .002). The SAR was more favorable during the second period in patients who developed their first metastasis in the regional lymph nodes (45.2% vs 32.9%, P = .017) or in distant sites (13.4% vs 2.0%, P = .0002) and this finding persisted in the multivariate analysis.CONCLUSIONS.Improvement of survival of CM patients diagnosed 1990–2001 as compared with 1976–1989 may not be entirely attributable to factors associated with early diagnosis and more favorable primary tumors. Therefore, factors of melanoma management, which changed between the 2 time periods, such as sentinel node biopsy, adjuvant treatment, structured follow‐up, and surgical interventions in distant metastasis, may have to be taken into account. Cancer 2007 © 2007 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Improvement of overall survival of patients with cutaneous melanoma in Germany, 1976–2001

Lasithiotakis

Leiter

Eigentler

et al. 2007

Cancer

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“…The median survival in stage IV is 6-8 months, the 5-year survival rate is at most 5% [2,3]. In individual cases, however, long-term survival is possible after the resection of metachronous metastases [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Survival in Stage IV Melanoma after Repetitive Surgical Therapy

Tomov¹,

Siegel²,

Bembenek³

2008

Onkologie

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Background: Surgical therapy in patients with stage IV melanoma is controversial and always an individual decision. Case Report: We report the case of a young melanoma patient, who underwent resection of 5 distant metastases from 4 different organ systems. Thereby, the patient achieved a stable state of disease and a good quality of life for up to now 67 months without any evidence for further tumor manifestations at present. A systemic chemo- or immunotherapy was never applied. Conclusion: In selected patients with stage IV melanoma, surgery alone can provide long-term survival with good quality of life.

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“…En la TC, estas masas, son con frecuencia heterogéneas, voluminosas y engloban órganos vecinos 3 . En el trabajo de Haigh y cols 6 , de 83 pacientes con metástasis adrenales por melanoma, 27 fueron intervenidos quirúrgicamente, 18 con intención curativa, todos mediante cirugía abierta. La supervivencia media de todos los pacientes fue de 9,3 meses, siendo de 25,7 meses en los operados con intención curativa.…”

Section: Discussionunclassified

Adrenalectomía bilateral laparoscópica por metástasis asincrónica de melanoma: comunicación de un caso con sobrevida prolongada

2013

Rev Chil Cir

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Bilateral adrenalectomy for asynchronous metastases of a malignant melanomaClinical case: We report a 70 years old male with a history of an ear lobe melanoma with was excised seven years ago, who had a bronchial relapse and required a right pneumonectomy. During a follow up abdominal CAT scan, a 9 cm tumor in the left adrenal gland was detected. The patient was operated, performing a left adrenalectomy and nephrectomy. The pathologic study confirmed the presence of a fusocellular melanoma. One year later, a right adrenal mass was detected and excised. The pathological study of the piece again confirmed a metastasis of a malignant melanoma. The patient died due to progression of the disease, 10 years after the adrenalectomy.Key words: Adrenal metastases, laparoscopic adrenalectomy, melanoma. ResumenObjetivo: Presentar un caso de metástasis suprarrenal bilateral asincrónica de Melanoma cutáneo tratado con adrenalectomía laparoscópica bilateral. Caso clínico: Paciente de 70 años con antecedente de melanoma del pabellón auricular extirpado 7 años antes de su consulta urológica. Posteriormente, presenta una recidiva bronquial tratada con quimioterapia, radioterapia y neumonectomía derecha. En sus exámenes de seguimiento una Tomografía computada muestra el hallazgo incidental de una lesión tumoral de 9 cm en la glándula suprarrenal izquierda. Se realizó nefrectomía y adrenalectomía izquierda laparoscópica en bloque sin incidencias. El análisis histopatológico confirmó el hallazgo de una metástasis de melanoma fuso-celular. Un año después el paciente presenta un nuevo hallazgo incidental de un tumor de 3 cm en la glándula suprarrenal derecha, la cual fue tratada con adrenalectomía laparoscópica, y cuyo análisis histopatológico demostró metástasis de melanoma maligno. El paciente fallece por progresión de su enfermedad 10 años después de su cirugía suprarrenal. Conclusiones: En los pacientes con metástasis suprarrenal de melanoma, la adrenalectomía incrementa la supervivencia cáncer especifica en relación a los pacientes tratados sin cirugía. El abordaje laparoscópico constituye una alternativa terapéutica con menor morbilidad que la cirugía abierta en cirujanos con experiencia laparoscópica.Palabras clave: Metástasis suprarrenal, adrenalectomía laparoscópica, melanoma.

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Long-Term Survival After Complete Resection of Melanoma Metastatic to the Adrenal Gland

Abstract: Patients with adrenal metastases from melanoma, either isolated or with a limited number of additional metastases, may benefit from surgical resection if all visible disease can be removed. Patients with unresectable extra-adrenal disease achieve no survival benefit from adrenalectomy.

Cited by 64 publications

References 27 publications

Improvement of overall survival of patients with cutaneous melanoma in Germany, 1976–2001

Improvement of overall survival of patients with cutaneous melanoma in Germany, 1976–2001

Long-Term Survival in Stage IV Melanoma after Repetitive Surgical Therapy

Adrenalectomía bilateral laparoscópica por metástasis asincrónica de melanoma: comunicación de un caso con sobrevida prolongada

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