title: The Role of Surgery for Melanoma in an Era of Effective Systemic Therapy.
abstract: OBJECTIVE
  The recent discovery of effective systemic treatments for melanoma has dramatically improved the prognosis for patients with advanced disease. As a result, the multidisciplinary management of melanoma has evolved significantly. In the past decades surgery was reserved for symptomatic palliation in patients with metastatic melanoma. Today surgical treatment of patients responding to systemic therapies has become an integral part of disease control.
  
  
  RESULTS
  Current efforts are focused on minimizing the morbidity of surgery (laparoscopic inguinal lymph node dissection, selective completion lymphadenectomy) as well as combining surgery with systemic therapy in novel ways (neoadjuvant targeted and/or immunotherapy, isolated limb infusion/perfusion with systemic immunotherapy). This review examines the use of surgery for advanced melanoma in the era predating modern systemic therapy as well as potential applications moving forward.
authors.affiliation: Division of Surgical Oncology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
authors.forename: Siavash
authors.initials: S
authors.lastname: Raigani
authors.affiliation: Division of Surgical Oncology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
authors.forename: Sonia
authors.initials: S
authors.lastname: Cohen
authors.affiliation: Division of Surgical Oncology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA. gmboland@partners.org.
authors.forename: Genevieve M
authors.initials: GM
authors.lastname: Boland
mesh_terms: D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000473:pathology; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy; D016896:Treatment Outcome
keywords: Immunotherapy; Melanoma; Metastasectomy; Surgery; Targeted therapy