Annals of Surgical Oncology

, Volume 16, Issue 10, pp 2834–2839

Biological Factors, Tumor Growth Kinetics, and Survival After Metastasectomy for Pulmonary Melanoma

  • Jonathan H. Lee
  • Seza A. Gulec
  • Ainura Kyshtoobayeva
  • Myung-Shin Sim
  • Donald L. Morton
Melanomas

DOI: 10.1245/s10434-009-0583-5

Cite this article as:
Lee, J.H., Gulec, S.A., Kyshtoobayeva, A. et al. Ann Surg Oncol (2009) 16: 2834. doi:10.1245/s10434-009-0583-5

Abstract

Introduction

Approximately 23% of melanoma patients will eventually develop pulmonary metastases and have a median survival of only about 7–11 months. Because pulmonary metastasectomy can improve this statistic, we investigated clinicopathologic features and biological correlates that might be used to identify surgical candidates.

Methods

Archived operative specimens and clinical records were retrieved for 20 melanoma patients who underwent resection of isolated pulmonary metastases at the John Wayne Cancer Institute, Saint John’s Health Center. Five-year postmetastasectomy survival (PMS) rate was correlated with age, number of pulmonary metastases, tumor doubling time (TDT), tumor necrosis, and immunohistochemical expressions of four biological markers: Ki-67, glucose transporter-1 (Glut-1), caspase-3, and CD31.

Results

Median TDT was 61 days. On multivariate analysis, TDT (P = 0.008), Glut-1 intensity (P = 0.04), and CD31 expression (P = 0.004) were the significant predictors of PMS. Age, number of pulmonary metastases, tumor necrosis, and expression of Ki-67 or caspase-3 did not significantly impact survival. Median TDT was 56 days with Glut-1 expression versus 165 days without Glut-1 expression (P = 0.002), and Glut-1 staining intensity independently affected TDT (P = 0.012).

Conclusions

Surgical resection may be preferable to toxic systemic therapies in melanoma patients whose isolated pulmonary metastases have a long TDT (≥61 days) and no biopsy evidence of Glut-1 expression.

Copyright information

© Society of Surgical Oncology 2009

Authors and Affiliations

  • Jonathan H. Lee
    • 1
    • 2
  • Seza A. Gulec
    • 1
    • 3
  • Ainura Kyshtoobayeva
    • 4
  • Myung-Shin Sim
    • 5
  • Donald L. Morton
    • 1
  1. 1.Division of Surgical OncologyJohn Wayne Cancer Institute at Saint John’s Health CenterSanta MonicaUSA
  2. 2.Department of Surgery, Division of Surgical OncologyUMDNJ/RWJ Medical School, The Cancer Institute of New JerseyNew BrunswickUSA
  3. 3.Department of SurgeryFlorida International University College of MedicineMiamiUSA
  4. 4.Clarient Diagnostic ServicesAliso ViejoUSA
  5. 5.Department of BiostatisticsJohn Wayne Cancer InstituteSanta MonicaUSA

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