Melanoma M (Zero): Diagnosis and Therapy

Abstract

This paper reviews the epidemiology, diagnosis, and treatment of M zero cutaneous melanoma including the most recent developments. This review also examined the main risk factors for melanoma. Tumor thickness measured according to Breslow, mitotic rate, ulceration, and growth phase has the greatest predictive value for survival and metastasis. Wide excision of the primary tumor is the only potentially curative treatment for primary melanoma. The sentinel node biopsy must be performed on all patients who have a primary melanoma with a Breslow thickness > 1 mm, or if the melanoma is from 0,75 mm to 1 mm thick but it is ulcerated and/or the mitotic index is ≥1. Total lymph node dissection consists in removing the residual lymph nodes in patients with positive sentinel node biopsy, or found positive on needle aspiration biopsy, without radiological evidence of spread. Isolated limb perfusion and isolated limb infusion are employed in patients within transit metastases with a rate of complete remission in around 50% and 38% of cases. Electrochemotherapy is mainly indicated for palliation in cases of metastatic disease, though it may sometimes be useful to complete isolated limb perfusion. The only agent found to affect survival as an adjuvant treatment is interferon alpha-2. Adjuvant radiotherapy improves local control of melanoma in patients at a high risk of recurrence after lymph node dissection.

TLR7 Gln11Leu single nucleotide polymorphism and susceptibility to cutaneous melanoma

“…Cutaneous melanoma represents the most common type of tumor among young adults aged 25-29 years, and the second most common neoplasm in those aged 15-29 years (4,5). Thus, melanoma is currently a significant public health problem in fair-skinned populations worldwide (6). In parallel with the increase in incidence rate, there has also been an increase in the rate of melanoma associated-mortality (2).…”

“…Thus, melanoma is currently a significant public health problem in fair-skinned populations worldwide (6). In parallel with the increase in incidence rate, there has also been an increase in the rate of melanoma associated-mortality (2). Distant metastatic melanoma has a 5-year overall survival rate of only 5-10%, and a median survival of 6-10 months, depending on the site of metastasis (7).…”

Predstavitev Primera: Nodularni Melanom

“…Tveganje za melanom je pri belcih desetkrat večje kot pri ostalih rasah. 2 Tudi v Sloveniji opažamo podobno povečevanje incidence, saj se je groba incidenčna stopnja v letih od 1985 do 2004 pri ženskah povečala za trikrat (s 5,4 na 17,7/105), pri moških pa za štirikrat (s 4,1 na 17,1/105). 3 V Sloveniji je leta 2010 na novo zbolelo 469 ljudi.…”

“…Popoln odgovor se doseže v 58 %. 2 Zadnja tri leta sta bolnikom z metastatskim melanomom na voljo zdravili vemurafenib in ipilimumab, s katerima lahko pomembno podaljšamo preživetje. 15 Vemurafenib je tarčno zdravilo, namenjeno bolnikom z inoperabilnim ali metastatskim melanomom, pri katerem je ugotovljena mutacija BRAFV600E.…”

Matrix metalloproteinase-12 expression is increased in cutaneous melanoma and associated with tumor aggressiveness

“…It is highly malignant due to its ability of aggressive invasion and early metastasis, which cause dismal outcome of patients [2]. Unfortunately, cutaneous melanoma is the most common type of skin cancer, accounting for over 80 % of deaths arising from skin cancer worldwide [3].…”