PMID: 8970593Dec 1, 1996Paper

Surgical management of patients with intermediate thickness melanoma: current role of elective lymph node dissection

Seminars in Oncology
D J Cole, P L Baron

Abstract

The appropriate role of elective hymph node dissection (ELND) in patients with clinical stage I intermediate thickness melanoma lesions remains a dilemma. Despite an impressive number of carefully performed nonrandomized/retrospective studies and two criticized multi-institutional prospective randomized trials, a clear benefit from ELND is still debatable. As a result, there currently is no standard approach for selecting patients who should undergo this procedure. Further prospective trials performed by the Intergroup/National Cancer Institute and World Health Organization (WHO) Melanoma groups, addressing Intermediate thickness extremity and truncal lesions respectively, have recently been completed. No long-term survival data is yet available from either group. Potentially conflicting preliminary results recently presented noted a significant ELND survival advantage for a subgroup of men with axial lesions in the Intergroup study, and no differential in survival demonstrable for the World Health Organization study at a median follow-up of 4 years. One area of agreement among surgeons on either side of the controversy is the need to be able to identify in a minimally invasive manner stage I-II melanoma patients with clinicall...Continue Reading

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