Metastatic melanoma to the lung: long-term results of surgical excision.

The only long-term survivor of multiple bilateral pulmonary metastases from malignant melanoma after staged thoracotomies has been described, and a series of 18 patients who underwent pulmonary resection for metastatic malignant melanoma at one clinic have been reviewed. Median survival was 16.5 months and the 5 year survival rate was 11.1 percent. Forty-four percent of the patients had multiple metastases and 11.1 percent had bilateral metastases. There was no correlation between length of survival and disease-free interval, number of metastases, or the presence of unilateral versus bilateral tumor nodules. Twenty-seven percent of the patients had more metastases found intraoperatively than suspected preoperatively. Unfavorable results occurred when the extent of the disease required pneumonectomy. The current literature has also been reviewed and arguments have been made to support the surgical approach to carefully selected patients with metastatic melanoma to the lung.