Ribero Simone, Sportoletti Baduel Eugenio, Osella-Abate Simona, Dika Emi, Quaglino Pietro, Picciotto Franco, Macripò Giuseppe, Bataille Veronique
Section of Dermatologic Surgery, Department of Oncology, Città della Salute e della Scienza di Torino Hospital, Turin, Italy -
Section of Dermatology, Department of Medical Sciences, University of Turin, Turin Italy -
G Ital Dermatol Venereol. 2017 Aug;152(4):355-359. doi: 10.23736/S0392-0488.16.05358-X. Epub 2016 Jun 1.
The management of melanoma is constantly evolving. New therapies and surgical advances have changed the landscape over the last years. Since being introduced by Dr Donald Morton, the role of sentinel lymph node has been debated. In many melanoma centers, sentinel node biopsy is not a standard of care for melanoma above 1 mm in thickness. The results of the MSLT-II Trial are not available for a while and in the meantime, this procedure is offered as a prognostic indicator as it has been shown to be very useful for assessing risk of relapse. The biology of lymph node spread in melanoma is a complex field and there are many factors which influence it such as age, melanoma body site, thickness but other factors such as regression, ulceration and gender need further evaluation. In this review, we address the clinical value of sentinel lymph node biopsy and how its indication has changed over the years especially recently with the setup of many adjuvant trials which are offered to stage 3 melanomas.
黑色素瘤的治疗方法一直在不断发展。在过去几年中，新的治疗方法和手术进展改变了这一局面。自唐纳德·莫顿博士引入前哨淋巴结以来，其作用一直存在争议。在许多黑色素瘤中心，对于厚度超过1毫米的黑色素瘤，前哨淋巴结活检并非标准治疗手段。MSLT-II试验的结果还需要一段时间才能得出，在此期间，该手术作为一种预后指标被采用，因为它已被证明对评估复发风险非常有用。黑色素瘤淋巴结转移的生物学机制是一个复杂的领域，有许多因素会影响它，如年龄、黑色素瘤的身体部位、厚度，但其他因素如消退、溃疡和性别等还需要进一步评估。在这篇综述中，我们探讨了前哨淋巴结活检的临床价值，以及这些年来其适应证是如何变化的，尤其是最近随着许多针对III期黑色素瘤的辅助试验的开展。
