Surgical Management of Distant Melanoma Metastases

Until quite recently, surgical resection of distant melanoma metastases that were isolated or causing symptoms was the only therapeutic strategy with any realistic chance of prolonging the patient’s life or improving its quality. Today, however, systemic agents are available that are often effective, and the role of surgery for distant metastatic disease must be re-evaluated. This chapter reviews the current role of surgical excision of distant melanoma metastases, both with curative intent and as palliation. The importance of patient selection for such surgery is emphasized and the need to weigh up the likely benefits and risks of surgery in each patient. Although present-day nformation is outlined in the chapter, it is ighly likely that completely new management strategies will evolve over the next few years, as more experience is gained with neoadjuvant and postoperative adjuvant treatments, and even more effective systemic agents and combination therapies are introduced.