UZH-Logo

Maintenance Infos

Die Rolle der Chirurgie in der Behandlung des kutanen Melanoms


Guggenheim, M; Dummer, R; Giovanoli, P (2011). Die Rolle der Chirurgie in der Behandlung des kutanen Melanoms. Praxis, 100(15):911-916.

Abstract

Historically, melanoma patients were subject to wide local excisions and elective lymph node dissections. Both approaches were the focus of intense scrutiny in the past three decades, and many surgical dogmas were abolished. The role of surgery in providing local control over the primary tumor is largely undisputed. In addition, the surgical management strategies of the regional lymph nodes have undergone considerable change in the past; with lymphatic mapping and sentinel lymph node identification being the most relevant contribution, allowing selection of patients for adjuvant treatment (completion lymph node dissection, Interferon therapy). Surgery has also a place in palliative treatment of isolated systemic metastases for selected cases with good performance status in Stage IV melanoma.

Zusammenfassung:
Historisch wurden Melanompatienten weiträumigen lokalen Exzisionen und elektiven Lymphknotenausräumungen unterzogen. Beide Vorgehensweisen waren in den vergangenen drei Jahrzehnten Gegenstand intensiver Forschung; viele chirurgische Dogmen wurden in dieser Zeit verworfen. Die Rolle der Chirurgie bezüglich lokaler Kontrolle des Primärtumors wird heute kaum in Frage gestellt. Hingegen hat die Strategie des chirurgischen Managements der regionalen Lymphknoten in der nahen Vergangenheit beachtliche Veränderungen erfahren. Das lymphatische Mapping sowie die Identifikation des Sentinel-Lymphknotens gelten als wesentliche Bestandteile zur Selektion geeigneter Patienten für eine adjuvante Therapie (komplettierende Lymphknotendissektion, Immuntherapie mit Interferonen). Bei metastasierten Melanomen im Stadium IV kommt die Chirurgie in ausgewählten Fällen auch zur Behandlung isolierter systemischer Metastasen zur Anwendung.

Historically, melanoma patients were subject to wide local excisions and elective lymph node dissections. Both approaches were the focus of intense scrutiny in the past three decades, and many surgical dogmas were abolished. The role of surgery in providing local control over the primary tumor is largely undisputed. In addition, the surgical management strategies of the regional lymph nodes have undergone considerable change in the past; with lymphatic mapping and sentinel lymph node identification being the most relevant contribution, allowing selection of patients for adjuvant treatment (completion lymph node dissection, Interferon therapy). Surgery has also a place in palliative treatment of isolated systemic metastases for selected cases with good performance status in Stage IV melanoma.

Zusammenfassung:
Historisch wurden Melanompatienten weiträumigen lokalen Exzisionen und elektiven Lymphknotenausräumungen unterzogen. Beide Vorgehensweisen waren in den vergangenen drei Jahrzehnten Gegenstand intensiver Forschung; viele chirurgische Dogmen wurden in dieser Zeit verworfen. Die Rolle der Chirurgie bezüglich lokaler Kontrolle des Primärtumors wird heute kaum in Frage gestellt. Hingegen hat die Strategie des chirurgischen Managements der regionalen Lymphknoten in der nahen Vergangenheit beachtliche Veränderungen erfahren. Das lymphatische Mapping sowie die Identifikation des Sentinel-Lymphknotens gelten als wesentliche Bestandteile zur Selektion geeigneter Patienten für eine adjuvante Therapie (komplettierende Lymphknotendissektion, Immuntherapie mit Interferonen). Bei metastasierten Melanomen im Stadium IV kommt die Chirurgie in ausgewählten Fällen auch zur Behandlung isolierter systemischer Metastasen zur Anwendung.

Altmetrics

Downloads

1 download since deposited on 11 Feb 2012
0 downloads since 12 months
Detailed statistics

Additional indexing

Other titles:The role of surgery in the treatment of cutaneous melanoma
Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Division of Surgical Research
04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
04 Faculty of Medicine > University Hospital Zurich > Clinic for Reconstructive Surgery
Dewey Decimal Classification:610 Medicine & health
Language:German
Date:2011
Deposited On:11 Feb 2012 09:51
Last Modified:05 Apr 2016 15:33
Publisher:Hans Huber
ISSN:1661-8157 (P) 1661-8165 (E)
Publisher DOI:10.1024/1661-8157/a000613
Official URL:http://www.verlag-hanshuber.com/zeitschriften/journal.php?abbrev=PRX&show=abstract&abstract=32175
PubMed ID:21792806
Permanent URL: http://doi.org/10.5167/uzh-58168

Download

[img]
Content: Published Version
Filetype: PDF - Registered users only
Size: 113kB
View at publisher

TrendTerms

TrendTerms displays relevant terms of the abstract of this publication and related documents on a map. The terms and their relations were extracted from ZORA using word statistics. Their timelines are taken from ZORA as well. The bubble size of a term is proportional to the number of documents where the term occurs. Red, orange, yellow and green colors are used for terms that occur in the current document; red indicates high interlinkedness of a term with other terms, orange, yellow and green decreasing interlinkedness. Blue is used for terms that have a relation with the terms in this document, but occur in other documents.
You can navigate and zoom the map. Mouse-hovering a term displays its timeline, clicking it yields the associated documents.

Author Collaborations