Diagnosis and treatment of melanoma: European consensus-based interdisciplinary guideline

详细信息    查看全文

• 作者：Claus Garbe ; Ketty Peris ; Axel Hauschild ; Philippe Saiag ; Mark Middleton ; Alain Spatz ; Jean-Jacques Grob ; Josep Malvehy ; Julia Newton-Bishop ; Alex ; er Stratigos ; Hubert Pehamberger ; Alex ; er Eggermont
• 关键词：Cutaneous melanoma ; Tumour thickness ; Excisional margins ; Sentinel lymph node dissection ; Interferon-α ; Adjuvant treatment ; Metastasectomy ; Systemic medical treatment
• 刊名：European Journal of Cancer
• 出版年：2010
• 出版时间：January 2010
• 年：2010
• 卷：46
• 期：2
• 页码：270-283
• 全文大小：244 K

文摘

Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumour and causes 90 % of skin cancer mortality. A unique collaboration of multi-disciplinary experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organization of Research and Treatment of Cancer was formed to make recommendations on CM diagnosis and treatment, based on systematic literature reviews and the experts’ experience. Diagnosis is made clinically and staging is based upon the AJCC system. CMs are excised with one to two centimetre safety margins. Sentinel lymph node dissection is routinely offered as a staging procedure in patients with tumours more than 1 mm in thickness, although there is as yet no resultant survival benefit. Interferon-α treatment can be offered to patients with more than 1.5 mm in thickness and stage II to III melanoma as an adjuvant therapy, as this treatment increases the relapse-free survival. The lack of a clear survival benefit and the presence of toxicity however limit its use in practice. In distant metastasis, all options of surgical therapy have to be considered thoroughly. In the absence of surgical options, systemic medical treatment is indicated, but with, to date, low response rates. Therapeutic decisions should be made by the melanoma team and the informed patient after full discussion of the options.