The indication for surgery will be more precise, thus avoiding a procedure that could be unnecessary in up to 80 percent of patients and the complications that it implies.
A thesis carried out at the Hospital General Universitario Santa Lucía de Cartagena analyzes what factors can
predict the presence of lymph node metastases in melanoma and propose a change in the management of these patients based on a more conservative treatment.
Taking into account the predictive factors of metastasis obtained in this study, the indication for surgery will be more precise,
thus avoiding a procedure that could be unnecessary in up to 80 percent of patients and the complications that it implies.
It is one of the conclusions of the thesis of the doctor of the General Surgery Service of the University Hospital Complex of Cartagena, Álvaro Martínez Manzano, which has been directed by the head of the General Surgery service of the University Hospital Complex of Cartagena, José Luis Vázquez Rojas, and the section chief of this service, María Dolores Balsalobre Salmerón, which is carried out within the PhD programs of the University of Murcia (UMU).
In recent years, the incidence of malignant melanoma, a highly aggressive and potentially fatal type of skin cancer, has increased in both women and men. Although its location would allow an easy and early diagnosis, there is currently a high rate of morbidity and mortality in these patients, due to their aggressiveness and unpredictable behavior. Treatment of non-metastatic melanoma is surgical. The primitive lesion must be excised, but
regional lymph node management is controversial.
Over the past decades, the management of malignant melanoma has evolved from the systematic performance of locoregional lymphadenectomy in the presence of palpable disease, to selective sentinel node biopsy (SLNB) and subsequent lymphadenectomy in the case of be this positive.
Lymphadenectomy is a surgical procedure based on the removal of local lymph nodes and subsequent microscopic analysis of them to rule out the presence of metastases. It is a technique that reports
complication rates as high as 40 percent, being some very serious, such as lymphedema.
In different series published recently, as well as in this study, it is observed that
only 20-30 percent of melanoma patients have metastatic involvement in the ‘non-sentinel’ nodes after a positive selective sentinel node biopsy. Thus, based on this doctoral thesis, studies will continue to be developed to establish with more scientific evidence what are the predictive factors of metastatic disease in Melanoma.