【摘要】 黑色素瘤的发病率逐年上升，治疗方式也较前有所改进。在外科治疗中，以往认为前哨淋巴结阳性患者均应行区域淋巴结清扫。然而，最新研究表明，前哨淋巴结阳性患者进行区域淋巴结清扫不仅会导致相关并发症发生率较高，而且并未提高患者的生存获益，仅能够改善区域控制率，并为预后评估提供信息。因此，基于前哨淋巴结肿瘤负荷和原发灶特征建立的风险分层模型来预测非前哨淋巴结状态，可能为豁免区域淋巴结清扫提供依据。本文就黑色素瘤患者非前哨淋巴结转移的危险因素及预后相关研究进展进行了综述分析，以期为临床诊疗提供参考。更多还原

【Abstract】 The incidence of melanoma has been steadily increasing,and treatment modalities have improved accordingly.Historically,any patient with a positive sentinel lymph node was recommended to undergo a completion lymph node dissection.However,recent studies have shown that completion lymph node dissection in sentinel lymph node-positive patients is associated with higher complication rates and confers no survival benefit,while yielding only improved regional disease control and additional prognostic information.Therefore,risk stratification models incorporating sentinel lymph node tumor burden and primary tumor characteristics have been developed to predict the status of non-sentinel lymph nodes,potentially allowing the omission of completion lymph node dissection in select patients.This review summarizes recent research on risk factors for non-sentinel lymph node involvement in melanoma and discusses their prognostic implications,with the aim of informing clinical practice.更多还原