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- W2907834852 abstract "There has been a historical emphasis on radical surgery both for the primary melanoma and for possible metastases within regional lymph nodes. This is because, in the absence of effective systemic therapy options, surgery was viewed as the only potential curative treatment. There are alternate hypotheses for the role of surgery in lymph node metastases in melanoma. Firstly, there is the ‘orderly progression’ of the metastatic process, initially through locoregional lymphatics to the regional lymph nodes, and subsequently to the second‐echelon lymph nodes and bloodstream. Therefore, early interruption of this process would in some way prevent further progression to distant visceral metastases and thereby improve overall survival (OS). The alternate hypothesis is that the development of metastatic disease within the locoregional lymph node(s) is an ‘indicator’ of metastatic potential and correlates with the development of distant metastases. However, removal of disease within lymph nodes at an early stage will not prevent the development of distant metastatic disease, which is governed by a complex interplay of the biology of the primary tumour and the host's innate defences.1 These two hypotheses are not mutually exclusive within a population of patients or indeed within an individual patient." @default.
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- W2907834852 date "2019-01-01" @default.
- W2907834852 modified "2023-10-18" @default.
- W2907834852 title "Recent developments in lymph node surgery for melanoma" @default.
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- W2907834852 doi "https://doi.org/10.1111/bjd.17143" @default.
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