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CHICAGO: Donald L. Morton, MD, FACS, a surgical oncologist and a clinical scientist from Santa Monica, CA, is the recipient of the 2008 Jacobson Innovation Award of the American College of Surgeons (ACS). Dr. Morton was honored with the award in recognition of his contribution of the technique of sentinel lymph node (SLN) biopsy to the field of surgery. His pioneering research efforts toward the development and clinical application of SLN biopsy have transformed the surgical management of many solid tumors, particularly melanoma and breast cancer. Currently, Dr. Morton is chief of the Melanoma Program and director of the Surgical Oncology Fellowship Program at the John Wayne Cancer Institute at Saint John’s Health Center, Santa Monica, CA. He also holds the post of professor of surgery emeritus at the School of Medicine of the University of California at Los Angeles (UCLA).

The 14^th Jacobson Innovation Award was presented to Dr. Morton at a dinner on June 13, 2008, at the John B. Murphy Memorial Auditorium in Chicago. The purpose of the award is to honor living surgeons who have been innovators of a new development or technique in any field of surgery. The award is made possible through a gift from Julius H. Jacobson II, MD, FACS, and his wife Joan. Dr. Jacobson is a general vascular surgeon known for his pioneering work in the development of microsurgery.

Dr. Morton’s discoveries have profoundly changed the treatment of human cancer. When Dr. Morton assumed the role of professor and chief of the Division of Surgical Oncology at UCLA School of Medicine in 1971, surgical oncology was not yet recognized as a specialty within general surgery. Dr. Morton’s division essentially provided a model for other medical schools to duplicate. In 1991, Dr. Morton with Michael Wayne founded the John Wayne Cancer Institute, where Dr. Morton became medical director and surgeon-in-chief.

His pioneering work with intratumoral bacille Calmette-Guerin (BCG) for nonspecific melanoma immunotherapy 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-approved cancer immunotherapy.

In the late 1970s, Dr. Morton changed the approach to melanoma surgery by introducing cutaneous lymphoscintigraphy to identify the regional lymphatic basin receiving drainage from a primary cutaneous melanoma. During the 1980s, he further refined lymphatic mapping to identify the pathway of sequential metastasis from a primary tumor to tumor-draining nodes within the regional nodal basin. He defined the SLN as the first tumor-draining node and therefore the most likely initial target of nodal metastasis. Extensive studies have confirmed that the pathologic status of the SLN accurately predicts the status of all nodes in the same drainage basin. SLN biopsy thus eliminates the need for more extensive staging lymphadenectomy and it improves the accuracy of nodal assessment by allowing closer scrutiny of a smaller specimen.

Dr. Morton’s innovative studies of sentinel node mapping resolved the debate on the value of prophylactic lymph node dissection for melanoma. SLN biopsy has become the standard of care for patients with early-stage malignant melanoma and breast cancer and it has been successfully adapted for staging of other solid malignancies with propensity to spread via the lymphatics to regional lymph nodes. Staging based on the sentinel node has also been incorporated in the American Joint Committee on Cancer’s staging guidelines for melanoma. In addition, immunologic and molecular characteristics of the sentinel node have improved understanding of the metastatic process and allowed development of more accurate biomarkers and prognostic indices. Dr. Morton’s seminal contribution has spared countless patients the morbidity of a complete regional lymph node dissection needlessly done in the absence of nodal metastasis. Intraoperative mapping of the sentinel node is a landmark achievement in surgical oncology. As a result of his contributions, Dr. Morton is recognized by his peers, trainees, and patients.

Dr. Morton received his medical degree from the University of California at San Francisco (UCSF) in 1958. He interned at UCSF Medical Center and began a surgical residency in general surgery, which was interrupted by a fellowship at the National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD. Upon completing his residency at UCSF Medical Center, Dr. Morton returned to the NCI to serve as senior surgeon in the Surgery Branch, eventually becoming head of the Tumor Immunology Section.

An active member of many prominent academic, medical, surgical, and scientific societies, Dr. Morton has served as president of the Society of Surgical Oncology, president of the World Federation of Surgical Oncology Societies, and president of the International Sentinel Node Society. He currently is principal investigator for four international randomized trials of treatment for melanoma.

Dr. Morton’s scientific contributions to the study of the immunology of cancer and the field of surgical oncology have yielded almost 700 publications in peer-reviewed journals and have garnered him a long series of prestigious awards and honors, including the Society of Surgical Oncology Heritage Award and the designation as outstanding investigator grant reviewer, National Cancer Program, NIH. Dr. Morton has received peer-reviewed funding from the NIH for 35 years, and his peer-reviewed grant awards put him at the top of a list of clinical investigators who received the most grant funding from NIH during 2000.

Dr. Morton also serves on the editorial boards of multiple prestigious surgery, surgical oncology, and oncology journals. During his career, he has mentored and trained more than 100 postdoctoral fellows in translational research related to the surgical treatment of cancer. More than 80 of these surgeons hold faculty positions in surgical oncology at prestigious medical schools.

Since its establishment in 1994, the Jacobson Innovation Award—administered by the Honors Committee of the American College of Surgeons—has been awarded to 14 prestigious surgeons, including Dr. Morton. Original thought combined with the first presentation of work that has led to a milestone in the advancement of surgical care is the main criterion for choosing a recipient of the Jacobson Innovation Award.

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient.  The College is dedicated to the ethical and competent practice of surgery.  Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients.  The College has more than 72,000 members and it is the largest organization of surgeons in the world.

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