Elective lymph node dissection for melanoma: Two perspectives

W. H. McCarthy, H. M. Shaw, N. Cascinelli, M. Santinami, F. Belli

Research output: Contribution to journalArticle

Abstract

Node dissection for melanoma remains the most important therapeutic decision for the optimal management of the patient with melanoma. In Australia and in some parts of the United States, the majority of patients with intermediate thickness melanoma (1.6-4.00 mm) will undergo elective lymph node dissection. In Europe, the majority of patients with similar lesions are treated with wide local excision only. The development of an agreed policy for node dissection for melanoma awaits the results of 2 current, prospective randomized trials confirming or disproving the efficacy of elective lymph node dissection. Non-randomized studies showing a benefit or not showing a benefit are readily available but the only 2 prospective randomized studies published to date showing a benefit, have been criticized on methodologic grounds. This paper summarizes the evidence and opinions on both sides of this debate. The clinician charged with responsibility for this important decision must, as yet, make the decision to dissect lymph nodes on the basis of a perspective derived from the best available evidence.

Original languageEnglish
Pages (from-to)203-213
Number of pages11
JournalWorld Journal of Surgery
Volume16
Issue number2
DOIs
Publication statusPublished - Mar 1992

ASJC Scopus subject areas

  • Surgery

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