Erschienen in:
04.01.2018 | Melanomas
Completing the Dissection in Melanoma: Increasing Decision Precision
verfasst von:
Mark B. Faries, MD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 3/2018
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Excerpt
For surgeons caring for patients with melanoma, treatment of regional lymph nodes has been controversial for well over a century. Over that time, two groups Galen might recognize as ‘sects’ developed. One group, proponents of the ‘incubator’ hypothesis, felt metastasis progresses sequentially, first to regional nodes and then on to distant sites. For them, early nodal surgery saves lives. The opposing ‘marker’ hypothesis saw lymph nodes merely as indicators of a metastatic phenotype, with surgical intervention unable to alter outcomes. As data became available to test these rival proposals, it is interesting to note how often the same information has been used to support contradictory conclusions. As the weight of available evidence has grown, controversies have diminished, and we may now be at a point where we can offer sound, rational advice to our patients as they weigh their options. …
