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Vol 5, No 1 (2009)
EXPERTS' OPINION
Published online: 2009-02-02
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Cutaneous melanoma - diagnostic and therapeutic guidelines

Włodzimierz Ruka, Maciej Krzakowski, Waldemar Placek, Piotr Rutkowski, Zbigniew I. Nowecki, Jacek Fijuth, Anna Nasierowska-Guttmejer, Arkadiusz Jeziorski, Lidia Rudnicka, Paweł Murawa, Janusz Słuszniak, Piotr Potemski, Renata Zaucha, Piotr J. Wysocki, Wojciech Polkowski, Grażyna Kamińska-Winciorek, Stanisław Bajcar, Wojciech Biernat, Edward Towpik
Onkol. Prak. Klin 2009;5(1):20-32.

open access

Vol 5, No 1 (2009)
EXPERTS' OPINION
Published online: 2009-02-02

Abstract

Excisional biopsy of suspicious melanomatous skin lesions likely to be diagnosed as early melanomas is crucial in establishing diagnosis and prognostic factors. Early diagnosis and surgical removal of cutaneous melanoma not only improves patients’ prognosis, but it is also associated with approximately 90% likelihood of cure. Next steps in the therapeutical management of cutaneous melanoma following excisional biopsy are radical scar excision with adequate margins and sentinel lymph node biopsy. Radical lymph node dissection is recommended in case of regional lymph node metastases. High-risk patients should be enrolled into prospective clinical trials on adjuvant therapy. The treatment of melanoma patients with distant metastases is of limited value. Long-term survival is confined to selected group of patients (metastases to extra-regional nodes, subcutaneous tissue and lungs). The benefits of immunotherapy/immunochemotherapy as compared to dacarbazine monotherapy have not been proven. Patients with metastatic disease should be treated within the frame of clinical trials.

Abstract

Excisional biopsy of suspicious melanomatous skin lesions likely to be diagnosed as early melanomas is crucial in establishing diagnosis and prognostic factors. Early diagnosis and surgical removal of cutaneous melanoma not only improves patients’ prognosis, but it is also associated with approximately 90% likelihood of cure. Next steps in the therapeutical management of cutaneous melanoma following excisional biopsy are radical scar excision with adequate margins and sentinel lymph node biopsy. Radical lymph node dissection is recommended in case of regional lymph node metastases. High-risk patients should be enrolled into prospective clinical trials on adjuvant therapy. The treatment of melanoma patients with distant metastases is of limited value. Long-term survival is confined to selected group of patients (metastases to extra-regional nodes, subcutaneous tissue and lungs). The benefits of immunotherapy/immunochemotherapy as compared to dacarbazine monotherapy have not been proven. Patients with metastatic disease should be treated within the frame of clinical trials.
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Keywords

cutaneous melanoma; diagnostics; therapy

About this article
Title

Cutaneous melanoma - diagnostic and therapeutic guidelines

Journal

Oncology in Clinical Practice

Issue

Vol 5, No 1 (2009)

Pages

20-32

Published online

2009-02-02

Bibliographic record

Onkol. Prak. Klin 2009;5(1):20-32.

Keywords

cutaneous melanoma
diagnostics
therapy

Authors

Włodzimierz Ruka
Maciej Krzakowski
Waldemar Placek
Piotr Rutkowski
Zbigniew I. Nowecki
Jacek Fijuth
Anna Nasierowska-Guttmejer
Arkadiusz Jeziorski
Lidia Rudnicka
Paweł Murawa
Janusz Słuszniak
Piotr Potemski
Renata Zaucha
Piotr J. Wysocki
Wojciech Polkowski
Grażyna Kamińska-Winciorek
Stanisław Bajcar
Wojciech Biernat
Edward Towpik

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