No abstract available.
Female ; Granulosa Cell Tumor ; Granulosa Cells ; Neoplasm Metastasis ; Ovary

INTRODUCTIONVisceral metastases from melanoma represent the poorest prognosis based according to the revised version of the AJCC staging system that recognises both clinical and pathological features distinctive to melanoma. Given that systemic treatments in metastatic melanoma to date remains inadequate, we evaluated the efficacy of surgical metastasectomy on survival outcomes.

MATERIALS AND METHODSBetween year 2000 and 2009, 23 patients with visceral metastases from melanoma were evaluated for metastasectomy. Retrospective review was undertaken of the specific therapy administered following consensus meeting of a multidisciplinary team.

RESULTSThere were 16 males and 7 females. Seventeen patients (74%) had metachronous gastrointestinal/liver metastases following previous treatment of the primary tumour. The median time to development of gastrointestinal/liver metastases, otherwise known as disease-free interval, was 49 (range, 5 to 559) months. Overall median survival period was 9 months, with a 1- and 3-year survival percentages of 39% and 30%, respectively. Survival was influenced by the number of metastases (P = 0.05) and the treatment received (P = 0.03). The disease-free and overall survival periods after metastasectomy were 14 and 21 months, respectively. The 1- and 3-year survival percentages were 60% and 40%, respectively. Patients with single site of metastasis survived longer than patients with more than one site of metastasis (P = 0.005).

CONCLUSIONPatients with visceral metastases from melanoma may derive survival benefit from metastasectomy over systemic therapy. Judicious selection of patients for metastasectomy is paramount for the success of treatment in this group of patients.

Aged ; Aged, 80 and over ; Female ; Gastrointestinal Neoplasms ; secondary ; surgery ; Humans ; Kaplan-Meier Estimate ; Liver Neoplasms ; secondary ; surgery ; Male ; Melanoma ; mortality ; pathology ; surgery ; Middle Aged ; Neoplasm Metastasis ; pathology ; therapy ; Prognosis ; Registries ; Retrospective Studies ; Singapore

INTRODUCTIONPatients with peritoneal metastases (PM) from hepatocellular carcinoma (HCC) often experience a rapid demise even after a complete removal of intrahepatic tumour. Localised PM may now be adequately controlled and managed with cytoreductive surgery (CRS).

TREATMENTThree patients underwent CRS for HCC PM.

OUTCOMEThe first patient survived 21 months from the time of CRS and is alive with the disease. The second patient died 4 months after CRS. The third patient survived 10 months since CRS and is also alive with the disease. Collectively, the survival of 24 patients with HCC PM extracted through a collective literature review who were treated with cytoreductive surgery had 1- and 2-year survival percentages of 83% and 71%, respectively.

CONCLUSIONCareful selection of patients with localised disease to the peritoneal cavity for CRS, taking into consideration the performance status, liver function and tumour biology may lead to a successful outcome in patients with HCC PM.

Carcinoma, Hepatocellular ; drug therapy ; pathology ; surgery ; Fatal Outcome ; Female ; Humans ; Liver Neoplasms ; drug therapy ; pathology ; surgery ; Male ; Middle Aged ; Peritoneal Neoplasms ; drug therapy ; secondary ; surgery ; Peritoneum ; pathology ; Young Adult