title: Regional node dissection for melanoma: techniques and indication.
abstract: Because virtually all microscopic nodal disease left untreated in melanoma patients will progress to clinically apparent macroscopic nodal disease, there is worse prognosis with macroscopic nodal disease, and ineffective systemic treatment currently exists, one must be cautious in favoring an observation approach to the regional basin in patients with a positive sentinel lymph node (SLN) in the hopes of avoiding the potential morbidity of a therapeutic node dissection. In the few patients with untreated microscopic nodal disease, the prognosis will be significantly worsened. Until further data are available, melanoma patients with a positive SLN by H&E analysis should proceed to a complete lymph node dissection.
authors.affiliation: Cutaneous Oncology Program, Lakeland Regional Cancer Center, 3525 Lakeland Hills Blvd., P.O. Box 91057, Lakeland, FL 33805-1057, USA.
authors.forename: James W
authors.initials: JW
authors.lastname: Jakub
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Reintgen
authors.forename: Steven
authors.initials: S
authors.lastname: Shivers
authors.forename: Solange
authors.initials: S
authors.lastname: Pendas
mesh_terms: D001365:Axilla / Q000473:pathology; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D037981:Neck Dissection; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D021701:Sentinel Lymph Node Biopsy; D016019:Survival Analysis