585 Surgical Excision of Isolated Gastrointestinal Metastasis from Malignant Melanoma – a 10-Year Survey
E Edah, J Y Kuan, K Pursnani, P Turner, C Ball, E Parkin, V D Shetty- Surgery
Abstract
Aim
Patients with malignant melanoma (MM) can develop isolated metastasis years after treatment of the primary. The spleen and small bowel are the recognised intra-abdominal sites of isolated metastasis. Excision of these metastases is recommended as several international case series have shown good prognoses after excision.
Method
This is a 10-year retrospective study of patients with MM diagnoses who underwent excision of isolated metastasis at our Trust. Splenectomy and small bowel resection unrelated to MM and patients with disseminated metastasis were excluded. The surgical management, postoperative outcome and overall survival of the patients were assessed.
Results
In these 10 years, 2160 patients diagnosed with MM were treated in our Trust. Of these, 4 patients developed isolated splenic metastasis, and one had an additional small bowel metastasis. The primary MM location was the trunk in 2 patients, the posterior auricular region, and the left forearm in the other 2 patients. The patients developed metastasis an average of 47 months after treatment of their primary MM (range 11 - 96 months). The first patient underwent laparoscopic excision; the subsequent 2 patients underwent robotic-assisted excision. The patient with 2 isolated metastases underwent an open procedure. All four patients had no postoperative complications. The mean length of stay was 6 days with a zero-readmission rate. The mean survival time was 28 months (range: 3-60 months).
Conclusions
Isolated metastasis from MM is very uncommon. Surgical excision should be offered to all suitable patients. The feasibility of minimally invasive surgical excision should be considered in each patient.