Annals of Surgical Oncology

, Volume 6, Issue 4, pp 336–344 | Cite as

Surgery for Melanoma Metastatic to the Gastrointestinal Tract

  • Shefali Agrawal
  • Tzy-Jyun Yao
  • Daniel G. Coit
Original Article


Background: Gastrointestinal (GI) metastasis from melanoma has a dismal prognosis with few long-term survivors. We evaluated the role of operative intervention for melanoma metastases to the GI tract and attempted to identify prognostic factors to improve selection of patients for surgery.

Methods: Between 1977 and 1997, 68 of the 7965 patients with melanoma admitted to Memorial Sloan-Kettering Cancer Center underwent surgical exploration for melanoma metastatic to the GI tract. Characteristics of the primary tumor, regional lymph nodes, and metastatic pattern were reviewed. Data concerning the presenting signs and symptoms, laboratory values, operative findings, extent of surgical resection, recurrence pattern, and survival were analyzed.

Results: The most common presenting clinical features included anemia (n = 41; 60%) or abdominal pain (n = 40; 59%). The most frequently involved portion of the GI tract was the small bowel (n = 62; 91%), and the most common operative procedure was small bowel resection (n = 54; 79%). Postoperative mortality and morbidity were 2.9% (n = 2) and 8.8% (n = 6), respectively. Presenting symptoms were relieved in 90% of patients (n = 61). Median survival for all 68 patients following operative intervention was 8.2 months, with 18% survival at 5 years. By multivariate analysis, complete resection rendering the patient free of all identifiable disease (n = 19, median survival 14.9 months, 38% survival at 5 years) and a low preoperative serum lactate dehydrogenase (LDH) (n = 28, median survival 13.6 months, 35% survival at 5 years) were identified as independent favorable prognostic factors for survival.

Conclusions: Operative intervention for melanoma metastatic to the GI tract is recommended for palliative reasons and can be performed with low morbidity and mortality. It is associated with prolonged survival in patients rendered free of all identifiable disease following surgical resection and in those with a low preoperative serum LDH.

Key Words

Gastrointestinal tract Melanoma Surgery 


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Copyright information

© The Society of Surgical Oncology, Inc. 1999

Authors and Affiliations

  • Shefali Agrawal
    • 1
  • Tzy-Jyun Yao
    • 2
  • Daniel G. Coit
    • 3
  1. 1.Department of SurgeryColumbia University College of Physicians and SurgeonsNew York
  2. 2.Departments of BiostatisticsMemorial Sloan-Kettering Cancer CenterNew York
  3. 3.Departments of SurgeryMemorial Sloan-Kettering Cancer CenterNew York

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