Locally Recurrent Malignant Melanoma Characteristics and Outcomes:0 A Single-Institution Study

Abstract

Despite improvements in the identification and treatment of melanoma, local recurrence continues to challenge the success of current melanoma therapy. A retrospective analysis of 1,996 patients presenting from 1990 to 1997 at the Pigmented Lesion Group of the University of Pennsylvania was performed to assess clinical characteristics and outcomes of locally recurrent melanoma. The cases were analyzed by chart and pathological slide review. A control group was identified for statistical comparison. The incidence of locally recurrent melanoma during the study period was 2.2%. Lentigo maligna melanoma (LMM) accounted for 37% of the local recurrences. Increased tumor thickness and microsatellites were associated with "early" local recurrence and decreased survival from time of recurrence. Nineteen percent of the local recurrences occurred more than 5 years after the initial definitive treatment. The preponderance of locally recurrent LMM suggests the need for refinements in the techniques of margin identification and surgical excision of LMM. Tumors with increased thickness and microsatellites should receive particularly close attention. Lastly, with nearly 20% of the local recurrences occurring more than 5 years after the initial date of treatment, the authors suggest extending the follow-up time for all melanoma lesions beyond 5 years.

Dendritic cells transduced with gp100 gene by RGD fiber-mutant adenovirus vectors are highly efficacious in generating anti-B16BL6 melanoma immunity in mice

“…The difference between AdRGD-gp100/ mBM-DCs and Ad-gp100/mBM-DCs in vaccine and therapeutic efficacy against B16BL6 melanoma reflected the gene transduction efficiency and the maturation status to mBM-DCs by AdRGD-gp100 and Ad-gp100. As the prognosis of patients with melanoma is generally poor even after surgery, chemotherapy, or radiotherapy, and the melanomas commonly metastasize, 43,44 the fact that immunization with AdRGD-gp100/mBM-DCs could demonstrate more potent therapeutic efficacy against pre-existing B16BL6 metastasis is significant. Taken together, our results indicate that highly efficient MAA gene transduction to DCs using AdRGD leads directly to the generation of very effective APCs and an improvement in the efficacy of DC-based immunotherapy against melanoma.…”

Is Sentinel Lymph Node Mapping Indicated for Isolated Local and In-Transit Recurrent Melanoma?

“…A lthough local recurrence in melanoma has an estimated incidence of only 3% to 7%, [1][2][3][4][5][6][7] it is often considered a manifestation of systemic disease and thus carries a dismal prognosis. Likewise, in-transit recurrence, although uncommon, often precedes systemic disease.…”

Management of lentigo maligna and lentigo maligna melanoma: Seminars in surgical oncology

“…The choice of treatment for LM/LMM is important as they have a higher incidence of recurrence than other CMM [38]. In lesions that are completely excised with histological confirmation, recurrence rates of 80% have been reported [39].…”