Perez Matthew C, Orcutt Sonia T, Zager Jonathan S
Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA.
Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA -
G Ital Dermatol Venereol. 2018 Feb;153(1):56-67. doi: 10.23736/S0392-0488.17.05768-6. Epub 2017 Sep 12.
Melanoma accounts for the majority of skin cancer-related deaths, and its incidence continues to rise worldwide. While advanced disease has historically been associated with poor long-term survival, early-stage disease has a favorable prognosis and therefore, early diagnosis is paramount. Resection of primary melanoma requires a balance of maximizing oncological outcome while minimizing morbidity. Wide excision with 1-2 cm margins, depending on depth of the tumor, is the standard of care for surgical treatment of primary, invasive melanoma. Sentinel lymph node biopsy is indicated for patients with clinically node-negative, intermediate-thickness primary melanomas but should also be considered in selected patients with thin and thick primaries. In this article, historical perspectives and key clinical trials regarding the current guidelines for the surgical management of primary melanoma are discussed.
黑色素瘤导致了大多数与皮肤癌相关的死亡，并且其发病率在全球范围内持续上升。虽然晚期疾病历来与长期生存率低相关，但早期疾病预后良好，因此早期诊断至关重要。原发性黑色素瘤的切除需要在最大化肿瘤学结果的同时最小化发病率之间取得平衡。根据肿瘤深度，切除边缘为1-2厘米的广泛切除是原发性侵袭性黑色素瘤手术治疗的标准护理方式。前哨淋巴结活检适用于临床淋巴结阴性、中等厚度原发性黑色素瘤的患者，但对于选定的薄型和厚型原发性黑色素瘤患者也应考虑。在本文中，将讨论关于原发性黑色素瘤手术管理当前指南的历史观点和关键临床试验。
