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One Step Surgery for Cutaneous Melanoma: "We Cannot Solve Our Problems with the Same Thinking We Used When We Created
1Medical Institute of the Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria; Onkoderma, Private Clinic for Dermatologic Surgery, Sofia, Bulgaria.
Open Access Macedonian Journal of Medical Sciences
|November 7, 2017
Summary
This study introduces a single-step surgical approach for melanoma diagnosis and treatment, improving patient outcomes and reducing healthcare costs. The innovative method combines diagnostic tools with a single surgical intervention, offering a more efficient melanoma management strategy.
Area of Science:
- Oncology
- Dermatology
- Surgical Innovation
Background:
- Current melanoma treatment guidelines often involve multiple surgical interventions, leading to patient distress and increased healthcare burdens.
- Standard protocols may not always align with optimal patient care timelines for re-excision or sentinel lymph node biopsy.
- Existing guidelines may not fully address the potential for lymph flow disruption post-excision.
Purpose of the Study:
- To present and evaluate a single-step surgical methodology for cutaneous melanoma diagnosis and treatment.
- To highlight the advantages of a combined diagnostic and therapeutic surgical approach over multi-step procedures.
- To advocate for revisions in current melanoma treatment guidelines based on the efficacy of the one-step method.
Main Methods:
- Clinical assessment, dermatoscopy, and high-frequency ultrasonography (HFUS) of the primary lesion and lymph nodes.
- A single surgical intervention encompassing primary tumor removal with appropriate margins.
- Optional intraoperative or post-histopathological assessment for sentinel lymph node biopsy and/or lymphadenectomy.
Main Results:
- The one-step surgery method allows for accurate patient status assessment and simultaneous diagnosis and treatment.
- This approach minimizes the need for multiple surgeries, reducing patient adverse effects and financial strain.
- The technique has demonstrated significant positive results in centers applying it, particularly in Bulgaria.
Conclusions:
- The one-step melanoma surgery is a viable, innovative, and efficient alternative to current multi-step treatment protocols.
- Current European and American melanoma treatment guidelines require significant updates to incorporate more patient-centric and cost-effective approaches.
- Further adoption and refinement of this single-step methodology could optimize melanoma patient care globally.
