Kirurško zdravljenje melanoma
Surgical treatment of melanoma

Authors

  • Marko Hočevar Onkološki inštitut, Ljubljana

Keywords:

surgery, melanoma, treatment

Abstract

Kožni melanom je z vidika zdravljenja kirurška bolezen, saj kirurgija predstavlja zelo pomemben način zdravljenja pri vseh stadijih bolezni. Ločimo kirurško zdravljenje primarne lezije, regionalnih, in-transit in oddaljenih zasevkov. Pri primarni leziji ločimo diagnostično in široko (radikalno) ekscizijo. Varnostni rob je pri prvi do 5 mm, pri drugi pa med 1 do 2 cm, odvisno od debeline melanoma. Pri regionalnih zasevkih melanoma govorimo glede na njihovo velikost o klinično okultnih in klinično prepoznavnih zasevkih. Prve ugotovimo s pomočjo biopsije sentinel bezgavke in jih nato zdravimo tako kot klinično prepoznavne zasevke z radikalno limfadenektomijo regionalne bezgavčne lože. In-transit zasevke lahko zdravimo s preprosto ekscizijo ali pa v primerih, ko jih je več in so locirani na ekstremitetah s pomočjo tehnično zahtevnih izolirane ekstremitetne perfuzije ali infuzije. Pri sistemskem razsoju je kirurško zdravljenje vedno prvi izbor zdravljenja, v kolikor je možno zasevke odstraniti v celoti.

Abstract (Eng)

From the treatment perspective, skin melanoma is a surgical disease, as surgery is a very important treatment modality for all stages of this disease. We distinguish between surgical treatments of primary lesions and regional, in-transit and distant metastases. Considering the primary lesion, we distinguish between diagnostic and wide (radical) excision, with the safety margin being up to 5 mm and 1-2 mm, respectively. Depending on their size, locoregional melanoma metastases are either clinically occult or clinically apparent. The first are detected with the help of sentinel lymph node biopsy and are afterwards treated in the same manner as clinically apparent metastases, namely with radical lymphadenectomy of the regional lymph node basin. In-transit metastases can be treated with a simple excision or, in cases of multiple metastases located on the extremities, with the help of technically demanding isolated limb perfusion or infusion. In a systematic assessment, surgical treatment is always the first choice if metastases can be removed completely.

Published

2013-12-15

How to Cite

Hočevar, M. (2013). Surgical treatment of melanoma. Onkologija : Slovenian Journal of Oncology, 17(2), 119–121. Retrieved from https://revijaonkologija.si/Onkologija/article/view/200

Issue

Section

Review Article