[Value of lymphatic outflow directed continuity dissection in melanoma surgery]

Radicality of the surgical procedure in patients with intermediate and high risk melanomas is enhanced by the additional removal of the transit tract between tumor and regional lymph node (continuity dissection). After introduction of the lymphatic out flow scintigraphy in 1984, the accurate removal of the transit tract is easily possible in tumors located on the trunk, the upper arm and the thigh as well as of the head/neck region. The main reasons for the improved survival rates are the exact removal of the transit tract together with potentially existing occult tumor cells or in transit metastases, respectively, as well as ectope lymph node metastases and the consequent elective lymph node dissection.