Metastatic melanoma of the gastrointestinal tract. Results of surgical management.

Between 1954 and 1989, 41 patients with melanoma metastatic to the gastrointestinal tract underwent surgical treatment at the Mayo Clinic, Rochester, Minn. The small bowel was most commonly involved (71%), followed by the stomach (27%), large bowel (22%), and esophagus (5%). Gross total excision of all intra-abdominal metastases was performed in 52% of patients. The postoperative mortality was 5% and the median patient survival was 0.8 years, with 1- and 5-year survival rates of 44% and 9%, respectively. Of the patient, tumor, and treatment variables evaluated, patients with small-intestinal metastases had a significantly worse prognosis. Although patients with melanoma metastatic to the bowel have a limited life expectancy, surgical resection of their metastases provides effective palliation. Operative treatment of selected patients with symptomatic melanoma metastatic to the gastrointestinal tract is a worthwhile undertaking.