The Angeles Clinic and Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
J Surg Oncol. 2022 Jan;125(1):34-37. doi: 10.1002/jso.26744.
Treatment of regional lymph nodes in melanoma has been controversial for more than a century. A series of clinical trials evaluating elective lymph node dissection and then sentinel lymph node biopsy have helped define the current standard of care. These trials resulted in increasingly selective application of surgical intervention for regional lymph nodes in melanoma. First by focusing on optimal candidates for elective lymph node dissection and then by identifying patients through sentinel lymph node biopsy. The current standard of sentinel lymph node biopsy for appropriately selected patients and nodal observation for many patients, even with involved sentinel nodes is both more accurate in staging and much less morbid than what came before.
治疗黑色素瘤的区域淋巴结一直存在争议，已有一个多世纪。一系列评估选择性淋巴结清扫术和前哨淋巴结活检的临床试验有助于确定当前的治疗标准。这些试验使黑色素瘤区域淋巴结的手术干预越来越具有选择性。首先通过关注选择性淋巴结清扫术的最佳候选者，然后通过前哨淋巴结活检确定患者。对于适当选择的患者，当前的前哨淋巴结活检标准以及对于许多患者的淋巴结观察（即使有受累的前哨淋巴结），在分期方面更加准确，而且比以前的方法要少得多。
