surgery of primary melanomas手术的原发性黑色素瘤.pdfVIP

Cancers 2010, 2, 824-841; doi:10.3390/cancers2020824 OPEN ACCESS cancers ISSN 2072-6694 /journal/cancers Review Surgery of Primary Melanomas Piotr Rutkowski 1,*, Marcin Zdzienicki 1, Zbigniew I. Nowecki 1 and Alexander C. J. van Akkooi 2 1 Soft Tissue/Bone Sarcoma and Melanoma Department, M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; E-Mails: mzdzienicki@coi.waw.pl (M.Z.); nowecki@coi.waw.pl (Z.I.N.) 2 Erasmus University Medical Center–Daniel den Hoed Cancer Center, Rotterdam, The Netherlands; E-Mail: a.vanakkooi@erasmusmc.nl (A.C.J.v.A.) * Author to whom correspondence should be addressed: E-Mail: rutkowskip@coi.waw.pl; Tel.: +48 22 546 2184, Fax: +48 22 643 9791. Received: 29 March 2010; in revised form: 2 May 2010 / Accepted: 5 May 2010 / Published: 11 May 2010 Abstract: Surgery remains the mainstay of melanoma therapy, regardless of the tumor site. Only the early diagnosis combined with proper surgical therapy currently gives patients affected by this malignancy the chance for a full cure. The main goal of surgical therapy is to provide the local control of the disease and to secure long-term survival of the patient without reasonable functional and esthetic impairment. The recommended method of biopsy—excisional biopsy, as an initial diagnostic and, to some extent, therapeutic procedure—is performed under local anesthesia as an elliptical incision with visual clear mar