Whooley B P, Wallack M K
Department of Surgery, St Vincent's Hospital & Medical Center of New York/New York Medical College, New York, 10011, USA.
Surg Oncol. 1995 Aug;4(4):187-95. doi: 10.1016/s0960-7404(10)80035-0.
The incidence of melanoma is rising more rapidly than any other malignancy. More conservative margins of excision have been established and the role of elective node dissection awaits determination by prospective randomized trials. Lymphoscintigraphy has clarified lymphatic drainage from watershed areas. Lymphatic mapping and sentinel node biopsy may lead to acceptance of selective lymphadenectomy, and also allows for more sensitive staging. Further advances in outcome require the development of effective systemic adjuvant therapies. Until such time, surgery continues to play a pivotal role in all stages.
黑色素瘤的发病率增长速度比其他任何恶性肿瘤都要快。已经确立了更保守的切除切缘，选择性淋巴结清扫的作用有待前瞻性随机试验来确定。淋巴闪烁造影已明确了分水岭区域的淋巴引流情况。淋巴图谱绘制和前哨淋巴结活检可能会使选择性淋巴结切除术得到认可，也能实现更精准的分期。要想在治疗效果上取得进一步进展，需要研发有效的全身辅助治疗方法。在此之前，手术在各个阶段仍起着关键作用。
