SURGICAL-TREATMENT OF MALIGNANT-MELANOMA

The surgical treatment of malignant melanoma is dependent on early dia gnosis and a thorough understanding of the options available to patien ts who present with more deeply invasive lesions. There has been a shi ft in therapy of primary skin lesions to using narrower (1-2 cm) margi ns of excision. Decisions regarding treatment of the regional lymph no des are predicated upon understanding the overall risk of metastatic s pread and delineating the pattern spread of the malignant cells. The c oncept of intraoperative lymphatic mapping can greatly aid the clinici an in deciding (1) which lymph node group is the primary drainage basi n for any particular area of skin, and (2) which lymph node is the fir st node to receive lymphatic drainage from any given area (the so-call ed ''sentinel lymph node.''). Surgical resection of metastases can res ult in prolongation of survival in carefully selected patients. Copyri ght (C) 1997 by W.B. Saunders Company.