Surgery for Distant Metastatic Melanoma Improves Survival

Excerpt

The results of surgical treatment of stage IV melanoma patients have improved considerably over the past two decades. This is not just the result of better or less invasive operations. The tumor marker S-100B has a modest 50 % positive predictive value but can draw attention to a silent distant metastasis.1 Considerable credit goes to the nuclear medicine physicians. ¹⁸F-fluoro-2-deoxy-d-glucose is avidly accumulated in melanoma cells and enables positron emission tomography (PET) to discern metastases as small as 2 mm. Hybrid PET/CT allows surgeons to pinpoint the location of a metastasis and to better plan the operation. Also, PET helps to exclude metastases elsewhere and thus selects the patients with truly limited hematogenous dissemination. As a result, the chance to cure a patient via surgery has improved, and fewer patients undergo a procedure from which they do not benefit in the end because of small metastases that become evident later on. …