Mohs Surgery Unit, Institute of Oncology Angel H. Roffo, University of Buenos Aires, Av San Martin 5481, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
Unit of Cutaneous Oncology and Mohs Surgery, Institute Alexander Fleming, Conesa 1003, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
Am J Clin Dermatol. 2018 Nov;19(Suppl 1):24-30. doi: 10.1007/s40257-018-0379-0.
Although significant progress has been made in the understanding of melanoma pathophysiology and therapy, patients with metastatic melanoma still have a poor prognosis. The management of regional nodes remains a matter of debate. By replacing elective lymph node dissection, sentinel lymph node biopsy has revolutionized the treatment of malignant melanoma. In this paper, the history of the procedure is traced, and the indication for completion lymphadenectomy after positive sentinel node biopsy is discussed in light of the recent studies that addressed this issue. The role of adjuvant therapies in the management of patients with stage III melanoma is also discussed.
尽管在黑色素瘤病理生理学和治疗方面已经取得了重大进展,但转移性黑色素瘤患者的预后仍然很差。区域淋巴结的处理仍然存在争议。通过取代选择性淋巴结清扫术,前哨淋巴结活检已经彻底改变了恶性黑色素瘤的治疗方法。本文追溯了该手术的历史,并根据最近解决这一问题的研究,讨论了在前哨淋巴结活检阳性时行淋巴结清扫术的适应证。本文还讨论了辅助治疗在 III 期黑色素瘤患者管理中的作用。