The surgical management of @entity320 has evolved over the last 100 years. when early concepts of lymphatic permeation of the @entity5 and @entity3 led surgeons to perform radical operative procedures. Wide excision of primary @entity320 is now performed with 1- to 2-cm radial margins, significantly reducing the need for complex plastic closures, skin grafts. and hospital admissions. Although elective lymph node dissection remains controversial as a therapeutic procedure, the development of SL has improved the staging of the regional lymph nodes and diminished the morbidity of lymph node dissection. The role of SL for routine care of @entity320 @entity1 remains unknown. Metastasectomy, which is the surgical resection of distant @entity3 with @entity5 -free surgical margins, has not been popular for AJCC stage IV @entity1 with multiple @entity3 , because surgery is considered a local therapy and therefore of little value for management of disseminated disease. Nevertheless, the many reports of long-term survival after resection of distant @entity320 @entity3 to diverse soft tissue and organ sites clearly indicate that this form of cytoreductive surgery can be extremely successful in carefully selected @entity1 . Unlike chemotherapy, complete surgical metastasectomy can rapidly render a @entity1 disease-free with only a short period of postoperative morbidity. Most @entity1 fully recover from the surgical procedure within 6 weeks, returning to most or all activities. The ability to select @entity1 for surgery is based on the development of more sophisticated imaging techniques, which allow better preoperative differentiation of @entity1 with single versus multiple @entity3 and improve the surgeon's ability to identify and resect multiple metastatic sites. The overall data suggest that @entity1 whose @entity3 can be completely resected will experience improved overall survival and occasional long-term cure regardless of the metastatic organ site and number of @entity3 . We believe that increased understanding of the biology of the primary and @entity3 , dramatic improvement in the accuracy of staging metastatic disease, and better techniques of surgical resection provide the best chance for long-term palliation or cure of @entity320 . Cytoreductive surgery should be considered a form of immunotherapy. The long-term clinical benefit of this therapy depends on the @entity1 's immune response to, the surgical reduction in @entity5 burden: an immune response that controls subclinical micrometastases should optimize postoperative survival.

Surgical treatment of XXXX .

@entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'tumors'] @entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity320 :: ('MESH:D008545', 'Disease') :: ['melanoma'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases']
@entity320 :: (MESH:D008545,Disease) :: ['malignant melanoma']
