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Many patients who have malignant melanoma, a type of skin cancer, can be cured with surgery if the disease is detected at a very early stage. In patients with metastatic melanoma, skin cancer that has spread to other parts of the body, the goal of treatment at this time is to improve quality of life and increase survival time. Surgery can benefit patients who have metastatic melanoma, if all of the detectable cancer can be removed. However, can a second surgery benefit patients who have a recurrence, or return of the cancer, after already having 1 surgery for metastatic melanoma? The answer is yes, according to researchers at the John Wayne Cancer Center in the United States.

The researchers reviewed the treatment outcomes for 211 patients with stage IV metastatic melanoma who were deemed clinically free of cancer after surgery. The melanoma recurred in 131 of these patients after an average of 8 months, but ranging up to 7.5 years. After a second surgical removal of cancer from 1 to 3 sites to which the cancer had spread in the body, the average survival time after surgery was 18 months. At 5 years after surgery, 20% of patients in whom removal of all detectable cancer was complete were alive. The longer the interval between the initial treatment and the recurrence, the longer was the survival time after the repeat surgery.

These findings show that a second surgery may benefit patients who have a recurrence of metastatic melanoma, provided that the surgical removal of all detectable cancer was complete. This is an important treatment option for patients with metastatic melanoma for whom other treatments are ineffective or for those who have a partial response to biologic therapies (or immunotherapies) or chemotherapy. (Journal of Surgical Oncology, Vol 71, No 4, pp 209-213, 1999)

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