Abstract
Purpose of Review: This review describes the evolving role of surgery in stage III and IV melanoma. Recent Findings: Surgery has been the first option to cure melanoma patients at initial diagnosis of metastatic spread: a complete surgical excision of the disease either in stage III or IV has been the gold standard for decades. A positive sentinel node biopsy (SNB) has been followed by a complete lymph node dissection (CLND) since the early stages of modern surgical oncology. However, since two randomized trials have indicated that a CLND does not improve survival in patients with a positive SNB, a CLND is no longer considered mandatory. A therapeutic lymph node dissection (TLND) is still offered to patients with macroscopic nodal disease and in highly selected cases, patients with distant melanoma metastases can be treated surgically as well. Also the availability of adjuvant, and in the future possibly neoadjuvant, systemic therapy have shifted the landscape to less extensive surgery in metastatic melanoma. Summary: With the development of new systemic options, surgery in metastatic melanoma has become more and more part of a multidisciplinary treatment: surgical indications are moving from previous standards to a new role.
| Original language | English |
|---|---|
| Article number | 98 |
| Journal | Current Oncology Reports |
| Volume | 21 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - Nov 1 2019 |
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Keywords
- Lymph node dissection
- Melanoma surgery
- Sentinel node biopsy
ASJC Scopus subject areas
- Oncology
Cite this
Surgery for Metastatic Melanoma : an Evolving Concept. / Testori, Alessandro A.E.; Blankenstein, Stephanie A.; van Akkooi, Alexander C.J.
In: Current Oncology Reports, Vol. 21, No. 11, 98, 01.11.2019.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Surgery for Metastatic Melanoma
T2 - an Evolving Concept
AU - Testori, Alessandro A.E.
AU - Blankenstein, Stephanie A.
AU - van Akkooi, Alexander C.J.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Purpose of Review: This review describes the evolving role of surgery in stage III and IV melanoma. Recent Findings: Surgery has been the first option to cure melanoma patients at initial diagnosis of metastatic spread: a complete surgical excision of the disease either in stage III or IV has been the gold standard for decades. A positive sentinel node biopsy (SNB) has been followed by a complete lymph node dissection (CLND) since the early stages of modern surgical oncology. However, since two randomized trials have indicated that a CLND does not improve survival in patients with a positive SNB, a CLND is no longer considered mandatory. A therapeutic lymph node dissection (TLND) is still offered to patients with macroscopic nodal disease and in highly selected cases, patients with distant melanoma metastases can be treated surgically as well. Also the availability of adjuvant, and in the future possibly neoadjuvant, systemic therapy have shifted the landscape to less extensive surgery in metastatic melanoma. Summary: With the development of new systemic options, surgery in metastatic melanoma has become more and more part of a multidisciplinary treatment: surgical indications are moving from previous standards to a new role.
AB - Purpose of Review: This review describes the evolving role of surgery in stage III and IV melanoma. Recent Findings: Surgery has been the first option to cure melanoma patients at initial diagnosis of metastatic spread: a complete surgical excision of the disease either in stage III or IV has been the gold standard for decades. A positive sentinel node biopsy (SNB) has been followed by a complete lymph node dissection (CLND) since the early stages of modern surgical oncology. However, since two randomized trials have indicated that a CLND does not improve survival in patients with a positive SNB, a CLND is no longer considered mandatory. A therapeutic lymph node dissection (TLND) is still offered to patients with macroscopic nodal disease and in highly selected cases, patients with distant melanoma metastases can be treated surgically as well. Also the availability of adjuvant, and in the future possibly neoadjuvant, systemic therapy have shifted the landscape to less extensive surgery in metastatic melanoma. Summary: With the development of new systemic options, surgery in metastatic melanoma has become more and more part of a multidisciplinary treatment: surgical indications are moving from previous standards to a new role.
KW - Lymph node dissection
KW - Melanoma surgery
KW - Sentinel node biopsy
UR - http://www.scopus.com/inward/record.url?scp=85074701471&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85074701471&partnerID=8YFLogxK
U2 - 10.1007/s11912-019-0847-6
DO - 10.1007/s11912-019-0847-6
M3 - Review article
C2 - 31696407
AN - SCOPUS:85074701471
VL - 21
JO - Current Oncology Reports
JF - Current Oncology Reports
SN - 1523-3790
IS - 11
M1 - 98
ER -