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Article |

En Bloc Resection of Primary Melanoma With Regional Lymph Node Dissection

Joseph G. Fortner, MD; David Schottenfeld, MD; Barbara J. Maclean
Arch Surg. 1975;110(5):674-676. doi:10.1001/archsurg.1975.01360110220038.
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En bloc resection of the primary melanoma with the regional lymph node drainage basin as a method of controlling disease within the area was used in 281 patients with stage I or II melanoma arising on the extremities (proximal to wrist or ankle) or on the trunk from 1954 through 1964. The en bloc operation was performed in 212 patients with a five-year cure of 73.5% (156 of 212). Seventy-six percent had histologically negative nodes. Only 2% developed regional recurrence.

Sixty-nine patients had a discontinuous dissection. The five-year cure was comparable: 68% (47 of 69). The incidence of histologically negative nodes was similar (77%), but the regional recurrence rate was 14%. This difference is significant at p <.01. The incontinuity or en bloc procedure appears highly effective for its designed purpose.


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