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Surgery for liver metastases from primary melanoma: a systematic review and meta-analysis

  • Systematic Reviews and Meta-analyses
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Abstract

Background

Historically , liver metastases due to melanoma have been associated with dismal prognosis. Moreover, the actual survival benefit from the treatment of melanoma liver metastases is still controversial. Hence, this study aims to evaluate the difference in surgical versus non-surgical options for melanoma liver metastases.

Methods

Four databases (PubMed, EMBASE, Scopus, and Cochrane Library) were searched from inception to July 17, 2022. Studies were included if they compared outcomes between surgical and non-surgical treatment for patients with liver metastases from resectable melanoma. Meta-analyses were performed for the outcomes of 1-year, 2-year, 3-year and 5-year OS. Sensitivity analyses were performed for outcomes with substantial statistical heterogeneity. To account for possible moderators that might contribute to statistical heterogeneity, univariate meta-regression with mixed-effects models and subgroup analyses were conducted for the outcome of 2-year OS.

Results

The search yielded 6610 articles; 13 studies were included in our analysis. Meta-analyses showed that survival outcomes were in favour of patients undergoing surgery as compared to non-surgery: 1-year OS (HR = 0.29, 95%CI 0.19–0.44, p < 0.00001), 2-year OS (HR = 0.19, 95%CI 0.09–0.38, p < 0.00001), 3-year OS (HR = 0.07, 95%CI 0.03–0.19, p < 0.00001) and 5-year OS (HR = 0.07, 95%CI 0.02–0.22, p < 0.00001). All included studies were of high quality. There was moderate-to-high statistical heterogeneity. Findings were robust to sensitivity analyses. Subgroup analyses and univariate meta-regression revealed neoadjuvant therapy and age as statistically significant subgroup and moderator respectively.

Conclusions

This study suggests that surgical treatment of melanoma liver metastases could offer better OS outcomes compared with non-surgical treatment.

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Authors and Affiliations

  1. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Mark Yeo & Yoshio Masuda

  2. Hepatobiliary Surgery and Liver Transplantation Unit, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Bilbao, Spain

    Mikel-Prieto Calvo

  3. Department of Hepatobiliary and Liver Transplant Surgery, A.O.R.N. Cardarelli, Naples, Italy

    Marcello Di Martino

  4. Hepatopancreatobiliary Unit, Parc Salut Mar University Hospital, Barcelona, Spain

    Benedetto Ielpo

  5. Pompeu Fabra University, Barcelona, Spain

    Benedetto Ielpo

  6. Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, 1 Outram Road, Singapore, 169608, Singapore

    Koh Ye-Xin

  7. Duke-National University of Singapore Medical School, Singapore, Singapore

    Koh Ye-Xin

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Contributions

Concept and design: M.P.C, K.Y.X. Administrative support: M.Y, Y.M. Provision of study materials or patients: M.Y, Y.M. Collection and assembly of data: M.Y, Y.M. Data analysis and interpretation: M.Y, Y.M, M.P.C, K.Y.X. Manuscript writing: M.Y, Y.M, M.P.C, M.D.M, B.I, K.Y.X. Final approval of manuscript: M.Y, Y.M, M.P.C, M.D.M, B.I, K.Y.X. All the authors have read and approved the final version of the manuscript for submission.

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Correspondence to Koh Ye-Xin.

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Mark Yeo and Yoshio Masuda are joint first authors.

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Yeo, M., Masuda, Y., Calvo, MP. et al. Surgery for liver metastases from primary melanoma: a systematic review and meta-analysis. Langenbecks Arch Surg 407, 3235–3247 (2022). https://doi.org/10.1007/s00423-022-02658-7

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  • DOI: https://doi.org/10.1007/s00423-022-02658-7

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