title: Management of regional lymph node basins in melanoma.
abstract: Of all malignancies, melanoma has the most rapid increase in incidence; in 2009 it was estimated to have had the fifth highest number of new cases overall. Surgical therapy remains the primary and most effective intervention for this disease. Over the past 20 years there has been a significant paradigm shift in the management of the regional nodal basin, driven predominantly by the introduction of sentinel lymph node biopsy (SLNB). This new technique has drastically altered the method of detecting nodal disease and has become a routine component of melanoma treatment. In addition to SLNB, a better understanding of ultrasound, fine-needle biopsy, and the considerable efforts to minimize the morbidity of surgical intervention has led to innovations in the management of patients with regional metastases. An overview of the current therapeutic options for managing patients with nodal disease follows.
authors: Department of Surgery, Emory University School of Medicine, Atlanta, GA.
authors: Timothy P
authors: TP
authors: Love
authors: Keith A
authors: KA
authors: Delman
references: J Clin Oncol. 2009 Nov 20;27(33):5614-9
references: 19786669
references: Lancet Oncol. 2003 Dec;4(12):748-59
references: 14662431
references: J Am Acad Dermatol. 2009 May;60(5):872-5
references: 19389531
references: J Urol. 2007 Mar;177(3):953-7; discussion 958
references: 17296386
references: Ann Surg Oncol. 2004 Dec;11(12):1079-84
references: 15576833
references: Arch Surg. 2005 Dec;140(12):1172-7
references: 16365238
references: Surgery. 1998 Oct;124(4):757-61; discussion 761-2
references: 9780998
references: Ann Surg. 2009 Mar;249(3):473-80
references: 19247037
references: Arch Surg. 2008 Sep;143(9):892-9; discussion 899-900
references: 18794428
references: Ann Surg Oncol. 2007 Oct;14(10):2867-75
references: 17671814
references: Eur J Surg Oncol. 2007 Feb;33(1):102-8
references: 17161577
references: Plast Reconstr Surg. 2005 Mar;115(3):721-8
references: 15731669
references: Am Surg. 2007 Jul;73(7):674-8; discussion 678-9
references: 17674939
references: Eur J Surg Oncol. 2009 Aug;35(8):877-83
references: 19054644
references: Ann Surg Oncol. 2005 Jan;12(1):18-23
references: 15827773
references: Arch Surg. 2002 May;137(5):543-7; discussion 547-9
references: 11982466
references: J Clin Oncol. 2010 Feb 10;28(5):847-52
references: 20065175
references: Ann Surg Oncol. 2010 Mar;17(3):731-7
references: 20183910
references: N Engl J Med. 2006 Sep 28;355(13):1307-17
references: 17005948
references: Int J Radiat Oncol Biol Phys. 2009 Apr 1;73(5):1376-82
references: 18774657
references: Br J Plast Surg. 2002 Jul;55(5):443-5
references: 12372379
references: Arch Otolaryngol Head Neck Surg. 2000 Mar;126(3):433-7
references: 10722024
references: Ann Surg Oncol. 2010 Jan;17(1):129-37
references: 19866238
references: Arch Esp Urol. 2006 Oct;59(8):849-52
references: 17153511
references: Am J Clin Pathol. 2007 Mar;127(3):385-97
references: 17276948
references: CA Cancer J Clin. 2004 May-Jun;54(3):131-49; quiz 182-4
references: 15195788
references: Melanoma Res. 2009 Feb;19(1):42-9
references: 19430405
references: Lancet. 1998 Mar 14;351(9105):793-6
references: 9519951
references: CA Cancer J Clin. 2009 Jul-Aug;59(4):225-49
references: 19474385
references: Cancer. 2004 Jan 15;100(2):383-9
references: 14716775
references: Arch Surg. 2005 Sep;140(9):865-71; discussion 871-2
references: 16172295
references: Cancer J. 2006 May-Jun;12(3):207-11
references: 16803679
references: J Clin Oncol. 2008 Sep 10;26(26):4296-303
references: 18606982
references: Arch Surg. 2006 Sep;141(9):877-82; discussion 882-4
references: 16983031
references: Arch Surg. 2000 Oct;135(10):1168-72
references: 11030873
references: Mayo Clin Proc. 1986 Sep;61(9):697-705
references: 3747613
references: Ann Surg Oncol. 2000 Mar;7(2):87-97
references: 10761786
references: Eur Urol. 2009 Nov;56(5):821-8
references: 19640633
references: Ann Oncol. 2006 Oct;17(10):1578-85
references: 16968875
references: Cancer. 2002 Jul 15;95(2):354-60
references: 12124836
references: Arch Surg. 2002 Oct;137(10):1101-5
references: 12361412
references: Ann Surg Oncol. 2010 Mar;17(3):670-3
references: 19953329
references: World J Urol. 2009 Apr;27(2):213-9
references: 19221761
references: Ann Surg Oncol. 2010 Mar;17(3):709-17
references: 19967459
references: Int Braz J Urol. 2006 May-Jun;32(3):316-21
references: 16813678
references: N Engl J Med. 1977 Sep 22;297(12):627-30
references: 895764
references: Surg Oncol. 1998 Jul-Aug;7(1-2):51-7
references: 10421506
references: Cancer Control. 2009 Jul;16(3):240-7
references: 19556964
references: J Am Acad Dermatol. 2006 Jan;54(1):19-27
references: 16384752
references: J Clin Oncol. 2009 Nov 10;27(32):5445-51
references: 19826131
references: J Clin Oncol. 2001 Aug 15;19(16):3622-34
references: 11504744
references: J Clin Oncol. 2006 Jun 20;24(18):2858-65
references: 16782925
references: Arch Surg. 1992 Apr;127(4):392-9
references: 1558490
references: Ann Surg Oncol. 2004 Mar;11(3):259-64
references: 14993020
references: Melanoma Res. 2009 Apr;19(2):94-9
references: 19262412
references: J Clin Oncol. 2003 Apr 1;21(7):1326-31
references: 12663722
references: Cancer. 2001 Jun 15;91(12):2409-16
references: 11413532
references: J Endourol. 2007 Apr;21(4):364-7; discussion 367
references: 17451323
references: Ann Surg Oncol. 2006 Dec;13(12):1655-63
references: 17016755
references: Ann Surg Oncol. 2006 Dec;13(12):1682-9
references: 17063307
references: ANZ J Surg. 2008 Nov;78(11):982-6
references: 18959697
references: Ann Surg Oncol. 2008 Jan;15(1):323-32
references: 17990041
references: Surg Oncol Clin N Am. 2007 Jan;16(1):35-54
references: 17336235
references: Ann Surg Oncol. 2000 Mar;7(2):160-5
references: 10761797
references: J Natl Compr Canc Netw. 2009 Mar;7(3):250-75
references: 19401060
references: Head Neck. 2005 Aug;27(8):718-21
references: 15952196
references: ANZ J Surg. 2006 Mar;76(3):98-9
references: 16626339
references: J Nucl Med. 2003 Apr;44(4):570-82
references: 12679402
references: Ann Surg Oncol. 2003 May;10(4):408-15
references: 12734090
references: Ann Surg Oncol. 1999 Apr-May;6(3):263-71
references: 10340885
references: Am J Surg. 1992 Nov;164(5):462-5; discussion 465-6
references: 1443370
references: Ann Surg. 2008 Sep;248(3):378-86
references: 18791358
references: Eur J Surg Oncol. 2000 Mar;26(2):172-6
references: 10744939
references: Ann Surg Oncol. 2008 Jun;15(6):1566-76
references: 18414952
references: Ann Surg. 1994 Dec;220(6):759-67
references: 7986143
references: J Natl Compr Canc Netw. 2006 Aug;4(7):666-84
references: 16884669
references: Cancer Metastasis Rev. 2006 Jun;25(2):221-32
references: 16770534