[Value of surgery for malignant melanoma in the context of current adjuvant and neoadjuvant treatment concepts].

Dermatologie (Heidelberg, Germany) Pub Date : 2025-06-01 Epub Date: 2025-05-08 DOI:10.1007/s00105-025-05511-2
Mareike Alter, Ralf Gutzmer
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引用次数: 0

Abstract

The field of melanoma treatment is also dynamic with respect to surgical procedures. In the treatment of the primary tumor the safety margins have been reduced based on study data. In surgery of the regional lymph nodes elective lymph node dissection has been discontinued in favor of sentinel lymph node (SLN) extirpation. Whether SLN extirpation can even be dispensed with in view of adjuvant treatment, particularly in patients with thicker primary tumors, needs to be further investigated. In the stage of regional macrometastasis, neoadjuvant or perioperative drug treatment should be considered before surgical measures. In the case of distant metastasis and disseminated disease, systemic treatment is also the first choice and in the case of local complications or oligoprogression under systemic treatment, surgical measures can also be considered.

【在当前辅助和新辅助治疗理念背景下,手术治疗恶性黑色素瘤的价值】。
黑色素瘤的治疗领域在外科手术方面也是动态的。在原发肿瘤的治疗中,根据研究数据,安全边际已经降低。在局部淋巴结的手术中,选择性淋巴结清扫已经停止,而倾向于前哨淋巴结(SLN)切除。考虑到辅助治疗,特别是对于原发肿瘤较厚的患者,是否可以不切除SLN,还需要进一步研究。在局部大转移期,手术前应考虑新辅助或围手术期药物治疗。对于远处转移和播散性疾病,全身治疗也是首选,如果在全身治疗下出现局部并发症或少进展,也可以考虑手术措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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