文章：

原发性皮肤黑色素瘤管理中广泛局部切除术的当代指南与证据综述

A Review of Contemporary Guidelines and Evidence for Wide Local Excision in Primary Cutaneous Melanoma Management

原文发布日期：23 February 2024

DOI: 10.3390/cancers16050895

类型: Article

开放获取: 是

英文摘要：

Surgical wide local excision (WLE) remains the current standard of care for primary cutaneous melanoma. WLE is an elective procedure that aims to achieve locoregional disease control with minimal functional and cosmetic impairment. Despite several prospective randomised trials, the optimal extent of excision margin remains controversial, and this is reflected in the persistent lack of consensus in guidelines globally. Furthermore, there is now the added difficulty of interpreting existing trial data in the context of the evolving role of surgery in the management of melanoma, with our increased understanding of clinicopathologic and genomic prognostic markers leading to the often routine use of sentinel node biopsy (SNB) as a staging procedure, in addition to the development of adjuvant systemic therapies for high-risk disease. An ongoing trial, MelMarT-II, has been designed with the aim of achieving a definitive answer to guide this fundamental surgical decision.

摘要翻译： 

手术广泛局部切除术（WLE）目前仍是原发性皮肤黑色素瘤的标准治疗方法。WLE是一种择期手术，旨在实现局部区域疾病控制，同时尽可能减少功能和外观损伤。尽管已有多项前瞻性随机试验，但最佳切除边缘范围仍存在争议，这反映在全球指南中持续缺乏共识。此外，随着手术在黑色素瘤治疗中角色的演变，现有试验数据的解读变得更加困难。我们对临床病理学和基因组预后标志物的理解不断加深，使得前哨淋巴结活检（SNB）作为分期程序已成为常规操作，同时针对高风险疾病的辅助全身治疗也在不断发展。一项名为MelMarT-II的正在进行中的试验，旨在为这一基本手术决策提供明确指导。

原文链接：

A Review of Contemporary Guidelines and Evidence for Wide Local Excision in Primary Cutaneous Melanoma Management