TY - JOUR
T1 - Surgical management of regional lymph nodes in cutaneous melanoma
AU - Balch, Charles M.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1980
Y1 - 1980
N2 - The initial evaluation of melanoma patients should include an assessment of the regional lymph nodes for metastatic disease. Clinical palpation of the nodes is an important but relatively crude index of metastatic melanoma. In clinically normal nodes, the risk of microscopic metastatic melanoma can be predicted by such prognostic factors as thickness, ulceration, and anatomic location of the melanoma. Other prognostic factors, including the level of invasion and growth pattern (nodular and superficial spreading) provided no additional predictive information after these dominant factors were accounted for. Stage I patients with intermediate thickness melanoma (0.76–4.00 mm) have an improved survival rate with elective Iymphadenectomy, while those with thin (<0.76 mm) and thick (≥4.00 mm) melanomas do not benefit from elective node dissection. Stage II melanoma patients with documented nodal metastases have relatively poor survival rates because of a high risk for distant microscopic metastases. A surgical strategy for deciding' about the timing, the extent, and the treatment goals of regional node dissection in melanoma patients is reviewed.
AB - The initial evaluation of melanoma patients should include an assessment of the regional lymph nodes for metastatic disease. Clinical palpation of the nodes is an important but relatively crude index of metastatic melanoma. In clinically normal nodes, the risk of microscopic metastatic melanoma can be predicted by such prognostic factors as thickness, ulceration, and anatomic location of the melanoma. Other prognostic factors, including the level of invasion and growth pattern (nodular and superficial spreading) provided no additional predictive information after these dominant factors were accounted for. Stage I patients with intermediate thickness melanoma (0.76–4.00 mm) have an improved survival rate with elective Iymphadenectomy, while those with thin (<0.76 mm) and thick (≥4.00 mm) melanomas do not benefit from elective node dissection. Stage II melanoma patients with documented nodal metastases have relatively poor survival rates because of a high risk for distant microscopic metastases. A surgical strategy for deciding' about the timing, the extent, and the treatment goals of regional node dissection in melanoma patients is reviewed.
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U2 - 10.1016/S0190-9622(80)80118-6
DO - 10.1016/S0190-9622(80)80118-6
M3 - Review article
C2 - 7217379
AN - SCOPUS:0019125672
SN - 0190-9622
VL - 3
SP - 511
EP - 524
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 5
ER -