Departments of Plastic & Hand Surgery, University of Sydney, Sydney, New South Wales, Australia. adrianling@hotmail
Australas J Dermatol. 2010 Feb;51(1):13-7. doi: 10.1111/j.1440-0960.2009.00575.x.
Guidelines for the surgical treatment of cutaneous primary malignant melanoma are well established; however, the approach to the treatment of the regional lymph nodes remains more controversial. In many centres, sentinel lymph node biopsy has been adopted as routine in the treatment of malignant melanoma for prognostic purposes, as it is not of proven therapeutic benefit. The Multicentre Selective Lymphadenectomy Trial II aims to determine the comparative benefits of subsequent completion lymphadenectomy versus observation in those found to have a positive sentinel node biopsy. Until results are available, the risks of the procedure must be weighed against the value of prognostic information gained from performing a sentinel node biopsy. In this retrospective analysis of sentinel lymph node biopsies at our institution, we show that in general, short-term morbidity associated with this procedure is low, but that morbidity is higher in a subgroup of people with higher weight or body mass index, and in those whose biopsy is located in the groin.
皮肤原发性恶性黑色素瘤的手术治疗指南已经确立；然而，区域淋巴结的治疗方法仍然存在更多争议。在许多中心，前哨淋巴结活检已被常规应用于恶性黑色素瘤的治疗，以用于预后评估，因为它没有被证明具有治疗益处。多中心选择性淋巴结切除术试验 II 旨在确定在发现前哨淋巴结活检阳性的患者中，后续完成淋巴结切除术与观察治疗的相对益处。在结果可用之前，必须权衡该手术的风险与从进行前哨淋巴结活检中获得的预后信息的价值。在我们机构的前哨淋巴结活检的回顾性分析中，我们表明，一般来说，该手术的短期发病率较低，但在体重或体重指数较高的亚组人群中，以及在活检位于腹股沟的人群中，发病率更高。
