En bloc resection of primary melanoma with regional lymph node dissection.
En bloc resection of the primary melanoma with the regional lymph node drainage basin as a method of controlling disease within the area was used in 281 patients with stage I or II melanoma arising on the extremities (proximal to wrist or ankle) or on the trunk from 1954 through 1964. The en bloc operation was performed in 212 patients with a five-year cure of 73.5% (156 of 212). Seventy-six percent had histologically negative nodes. Only 2% developed regional recurrence. Sixty-nine patients had a discontinuous dissection. The five-year cure was comparable: 68% (47 of 69). The incidence of histologically negative nodes was similar (77%), but the regional recurrence rate was 14%. This difference is significant at P < .01. The incontinuity or en bloc procedure appears highly effective for its designed purpose.
Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021, USA.
J G
JG
Fortner
D
D
Schottenfeld
B J
BJ
Maclean
D005121:Extremities; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000601:surgery*; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging