Kim Jae Jun, Park Jae-Kil, Wang Young-Pil
Department of Thoracic and Cardiovascular Surgery, College of Medicine, The Catholic University of Korea, Korea.
Korean J Thorac Cardiovasc Surg. 2011 Apr;44(2):165-8. doi: 10.5090/kjtcs.2011.44.2.165. Epub 2011 Apr 14.
The prognosis of melanoma metastasized to other organs is very poor. There have been many studies on metastatic melanoma in Western society, but there have been few studies done in Korea because of the small number of cases.
A retrospective review of 7 patients who underwent complete resection of pulmonary metastases from melanoma from January 2005 to December 2009 was performed. When the primary lesion was controlled or simultaneously controllable and no other metastatic lesion was found, pulmonary resections were performed. We analyzed the clinical prognoses after the initial melanoma diagnosis.
Of the seven patients, one was male and six were female. The mean age was 58.2 years (range 4571). Six patients had a single pulmonary lesion and one patient had three lesions confined to the same lobe. The mean disease-free interval was 43.5 months (0146 months). Before pulmonary resection, 4 patients had received systemic therapy. After pulmonary resection, 6 patients received systemic therapy. Complete resection was confirmed histologically. The metastasectomy was performed by wedge resection (6 patients) or lobectomy (1 patient). There were no mortalities or complications. After pulmonary resection, 1 patient had recurrent multiple lesions in the lung and 4 patients had metastases to other organs. The organs were the liver, brain, pleura, and lymph nodes. The mean observation time was 31.6 months and 3 patients died during observation. The mean survival was 27.7 months (14~60 months) and the 1-year and 3-year survival rates were 100% and 42%, respectively.
When patients were selected carefully, the complete resection of pulmonary metastatic lesions was considered a major therapeutic tool.
黑色素瘤转移至其他器官的预后非常差。西方社会对转移性黑色素瘤已有很多研究，但在韩国，由于病例数量少，相关研究较少。
对2005年1月至2009年12月间7例行黑色素瘤肺转移灶完全切除的患者进行回顾性研究。当原发灶得到控制或可同时控制且未发现其他转移灶时，行肺切除术。我们分析了黑色素瘤初次诊断后的临床预后。
7例患者中，1例男性，6例女性。平均年龄58.2岁（范围4571岁）。6例患者有单个肺转移灶，1例患者有3个局限于同一肺叶的转移灶。平均无病间期为43.5个月（0146个月）。肺切除术前，4例患者接受过全身治疗。肺切除术后，6例患者接受了全身治疗。组织学检查证实为完全切除。转移灶切除术采用楔形切除术（6例）或肺叶切除术（1例）。无死亡或并发症发生。肺切除术后，1例患者肺部出现复发性多发转移灶，4例患者出现其他器官转移。转移器官为肝脏、脑、胸膜和淋巴结。平均观察时间为31.6个月，观察期间3例患者死亡。平均生存期为27.7个月（14~60个月），1年和3年生存率分别为100%和42%。
经仔细挑选患者后，肺转移灶的完全切除可被视为一种主要的治疗手段。
