Abstract The biological behavior of malignant melanoma is so ubiquitous that the outcome, in any given instance, may bear no predictable relationship to the choice of therapy. This paradox is especially evident when one considers that the primary lesion, when on the skin, is ordinarily readily accessible to inspection and palpation and, therefore, should lend itself to effective eradication at an early stage. Until such time as our knowledge of cellular chemistry permits a chemotherapeutic attack on the disease, the surgeon is obliged to pursue a vigorous course of extirpative therapy that can accomplish no more than physical separation of the disease from the host, in one "region" of the body. While there is uniform agreement that wide regional excision of melanoma is the basis of primary treatment, there is a considerable divergence of opinion on two points. 1) How "wide" is wide surgical excision, and 2) what is the role References 1. Allen, A. C., and Spitz, S.: Malignant Melanoma , Cancer , 6:1, 1953.Crossref 2. Block, G. E., and Hartwell, S. W.: Malignant Melanoma: A Study of 217 Cases , Ann Surg 154: 74, 1961.Crossref 3. Catlin, D.: Melanomas of the Skin of the Head and Neck , Ann Surg 140:796, 1954.Crossref 4. Daland, E. M.: Malignant Melanoma: Personal Experience With 170 Cases , New Eng J Med 260:453, 1959.Crossref 5. Johnson, R. E.: Occult Lymphatic Metastases in Malignant Melanoma of the Skin , Ann Surg 146:931, 1957.Crossref 6. Kragh, L. V., and Erich, J. B.: Malignant Melanomas of the Head and Neck , Ann Surg 151: 91, 1960. 7. Lund, R. H., and Ihnen, M.: Malignant Melanoma: Clinical and Pathologic Analysis of 93 Cases; Is Prophylactic Lymph Node Dissection Indicated? Surgery 38:652, 1955. 8. McCune, W. S., and Letterman, G. S.: Malignant Melanoma: Ten-Year Results Following Excisónal and Regional Gland Resection , Ann Surg 141:901, 1955.Crossref 9. Meyer, H. W., and Gumport, S. L.: Malignant Melanoma: Appraisal of the Disease and Analysis of 105 Cases , Ann Surg 138:643, 1955.Crossref 10. Pack, G. T.: End Results in the Treatment of Malignant Melanoma: A Later Report , Surgery 46:447, 1959. 11. Royster, H. P., and Baker, L. M.: The Management of Malignant Melanoma , Ann Surg 145:888, 1957.Crossref 12. Vogler, W. R.; Garland, D. P.; and Wilkins, S. A.: A Clinical Evaluation of Malignant Melanoma , Surg Gynec Obstet 108:586, 1958.
Archives of Surgery – American Medical Association
Published: Nov 1, 1963
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