Surgery for Metastatic Melanoma: an Evolving Concept.

Surgery for Metastatic Melanoma: an Evolving Concept.

Publication date: Nov 06, 2019

This review describes the evolving role of surgery in stage III and IV melanoma.

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. 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.

Testori, A.A.E., Blankenstein, S.A., and van Akkooi, A.C.J. Surgery for Metastatic Melanoma: an Evolving Concept. 24687. 2019 Curr Oncol Rep (21):11.

Concepts Keywords
Adjuvant Metastatic melanoma
Gold Standard Surgery
Lymph Node Dissection Medicine
Macroscopic Medical specialties
Melanoma Clinical medicine
Metastases RTT
Metastatic Oncology
Neoadjuvant Surgical oncology
Sentinel Node Biopsy Cancer
Surgical Oncology Melanoma
Systemic Therapy Lymphadenectomy
Sentinel lymph node


Type Source Name
disease MESH Melanoma
disease DOID Melanoma
pathway BSID Melanoma
disease MESH diagnosis
drug DRUGBANK Gold
disease MESH metastases
disease MESH development


Original Article

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