Surgical management of distant metastases.

摘要: Although the location of metastases is prognostic importance in stage IV melanoma, as seen revised AJCC staging classification system and other studies, certain guiding principles apply to patients who have any disease. Close follow-up patient has melanoma may identify surgically resectable metastatic disease, although this method controversial. Components monitoring include careful questioning determine symptoms, such cough, abdominal pain, or headaches; physical examination for evidence skin, soft tissue, lymph node metastases; screening tools, radiographs laboratory tests. Identifying disease at earliest possible crucial surgical resection be an option. Patients should also thoughtfully evaluated possibility a complete re-section. Complete metastectomy, regardless anatomic site, confers survival advantages not with treatment modalities. This aggressive approach tempered knowledge that incomplete resections put increased risk without proven benefit, reserved only palliation symptoms. Systemic adjuvant therapies are evolving, but do yet confer advantage resection. Until novel drug show efficacy significantly prolong consideration given metastectomy if technically feasible.