Therapy for cutaneous melanoma: an update.
This article reviews the current therapy for cutaneous melanoma. Diagnosis, staging, and prognostic evaluation, which are crucial to proper management, are discussed. Surgical excision is the treatment of choice for primary melanoma. The resection margins should be tailored to tumor thickness. Guidelines for surgery are presented. The controversy about elective regional lymph node dissections is discussed. Limb perfusion, chemotherapy, immunotherapy, radiotherapy, and hormonal therapy as adjuvant treatments of primary melanomas as well as the treatment of disseminated melanomas are reviewed and new developments are highlighted. Guidelines for the management of metastatic melanoma at various sites are given. Special issues such as "pregnancy/estrogen and melanoma" and "borderline melanoma" are discussed and approaches to these problems are suggested. Recommendations are given for the follow-up and counseling of patients with melanoma.
Ho
V C
VC
Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston 02114.
Sober
A J
AJ
D000328:Adult; D001706:Biopsy; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods; D008545:Melanoma / Q000188:drug therapy / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011247:Pregnancy; D011379:Prognosis; D012878:Skin Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*
D003606:Dacarbazine