m E WORLD JOURNAL OF SURGICAL ONCOLOGY

In 2010, the estimated incidence of melanoma was 68,130 with approximately 8,700 deaths [1]. The annual incidence of melanoma continues to increase [1,2]. Metastatic mel-anoma has a poor prognosis with a median survival of 6 to 8 months and a 5-year survival of approximately 6% [3,4]. Liver metastases are diagnosed in 10 to 20 % of patients with metastatic melanoma and are associated with a poor prognosis and decreased mean survival of 4.4 months [5]. The Food and Drug Administration (FDA) has approved four systemic therapies for the treatment of patients with metastatic melanoma. Systemic high-dose IL-2 has an objective response rate of approximately 15 % and a durable long-term complete response rate of 4 to 5 % [6]. Dacarbazine has an objective response rate of 12 % with 2 to 3 % complete responses that are rarely durable [7]. Most recently, two additional agents * Correspondence