In Memoriam: Donald L. Morton, MD (1934–2014): An Icon in Surgical Oncology

Abstract

Over a half century career, Dr. Donald L. Morton changed our melanoma surgical practice and our oncology management on a global basis. His pioneering clinical research efforts in the development and clinical application of sentinel lymph node biopsy (SLNB) have transformed the surgical management of many solid tumors, particularly melanoma and breast cancer. 3,4 In these latter two cancers, SLNB has replaced complete lymphadenectomy for staging the regional nodes, thereby reducing healthcare costs in the United States by about $3.5 billion each year. He has also conducted numerous clinical research projects that have shaped our perspective and clinical management of our cancer patients, particularly in the field of melanoma. His pioneering work with intratumoral bacille CalmetteGuerin (BCG) for melanoma represented the first successful clinical application of immunotherapy against a metastatic human cancer. His work with BCG in melanoma metastatic to the bladder also laid a foundation for the use of intravesical BCG in superficial bladder cancer, which became the first US Food and Drug Administration (FDA)-approved cancer immunotherapy. 5 He was also one of the pioneers for performing limb salvage surgery and pulmonary metastasectomy for soft tissue sarcomas. 6 Although all of these made significant advances using the instruments of clinical trials, Dr. Morton was also a translational researcher who made fundamental discoveries in the field of tumor immunology and immunotherapy that has stimulated an entire field of inquiry.When Dr. Morton's scientific journey is examined from the perspective of a surgical investigator, he has few peers. He defined his approach as follows: ''Our goal as cancer researchers is to make things better. We identify problems with the status quo, then try to discover better ways to do things.'' His research has credibility and reproducibility because he rigorously tested his hypotheses using the structure of prospective clinical trials, sophisticated database analyses, and multidisciplinary collaborations. He was an outstanding surgeon, as well as an accomplished oncologist.

Donald L. Morton Memorial Lecture: the legacy of Donald Morton: past, present and future

“…His presentation of the sentinel node technique to the Society of Surgical Oncology was followed by almost 2 years of failed efforts to gain acceptance of the manuscript related to that work for publication. Eventually it was published and went on to become one of the most highly cited papers in oncology [ 9 ]. Similarly, when the randomized Phase 3 trials evaluating his vaccine failed to show a survival benefit in the vaccine arm.…”