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Laparoscopic liver resection for metastatic melanoma

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Abstract

Background

Stage IV metastatic melanoma carries a poor prognosis. In the case of melanoma liver metastasis (MLM), surgical resection may improve survival and represents a therapeutic option, with varying levels of success. Laparoscopic liver resection (LLR) for metastatic melanoma is poorly studied. The aim of this study was to analyze the outcomes of LLR in patients with MLM.

Materials and methods

Between April 2000 and August 2013, 11 (1 cutaneous, 9 ocular and 1 unknown primary) patients underwent LLR for MLM at Oslo University Hospital—Rikshospitalet and 13 procedures in total were carried out. Perioperative and oncologic outcomes were analyzed. Postoperative morbidity was classified using the Accordion classification. Kaplan–Meier method was used for survival analysis.

Results

A total of 23 liver specimens were resected. The median operative time was 137 (65–470) min, while the median blood loss was less than 50 (<50–900) ml. No intraoperative unfavorable incidents and 30‐day mortality occurred. Median follow-up was 33 (9–92) months. Ten patients (91%) developed recurrence within a median of 5 months (2–18 months) and two patients underwent repeat LLR for recurrent liver metastases. One-, three-, and five-year overall survival rates were 82, 45 and 9%, respectively. The median overall survival was 30 (9–92) months.

Conclusion

Perioperative morbidity and long-term survival after LLR for MLM seems to be comparable to open liver resection. Thus, LLR may be preferred over open liver resection due to the well-known advantages of laparoscopy, such as reduced pain and improved possibility for repeated resections.

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Authors and Affiliations

  1. The Intervention Centre, Oslo University Hospital – Rikshospitalet, Pb. 4950 Nydalen, 0424, Oslo, Norway

    Davit L. Aghayan, Airazat M. Kazaryan, Åsmund Avdem Fretland, Mushegh A. Sahakyan & Bjørn Edwin

  2. Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Oslo, Norway

    Åsmund Avdem Fretland, Bård I. Røsok, Bjørn Atle Bjørnbeth & Bjørn Edwin

  3. Department of Gastrointestinal Surgery, Akershus University Hospital, Lørenskog, Norway

    Airazat M. Kazaryan

  4. Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    Davit L. Aghayan, Åsmund Avdem Fretland, Mushegh A. Sahakyan & Bjørn Edwin

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  1. Davit L. Aghayan
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  2. Airazat M. Kazaryan
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Correspondence to Davit L. Aghayan.

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Davit L. Aghayan, Airazat M. Kazaryan, Åsmund Avdem Fretland, Mushegh A. Sahakyan, Bård I. Røsok, Bjørn Atle Bjørnbeth, and Bjørn Edwin have no conflicts of interest or financial ties to disclose.

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Aghayan, D.L., Kazaryan, A.M., Fretland, Å.A. et al. Laparoscopic liver resection for metastatic melanoma. Surg Endosc 32, 1470–1477 (2018). https://doi.org/10.1007/s00464-017-5834-0

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  • DOI: https://doi.org/10.1007/s00464-017-5834-0

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