title: Malignant melanoma in the 21st century, part 2: staging, prognosis, and treatment.
abstract: Critical to the clinical management of a patient with malignant melanoma is an understanding of its natural history. As with most malignant disorders, prognosis is highly dependent on the clinical stage (extent of tumor burden) at the time of diagnosis. The patient's clinical stage at diagnosis dictates selection of therapy. We review the state of the art in melanoma staging, prognosis, and therapy. Substantial progress has been made in this regard during the past 2 decades. This progress is primarily reflected in the development of sentinel lymph node biopsies as a means of reducing the morbidity associated with regional lymph node dissection, increased understanding of the role of neoangiogenesis in the natural history of melanoma and its potential as a treatment target, and emergence of innovative multimodal therapeutic strategies, resulting in significant objective response rates in a disease commonly believed to be drug resistant. Although much work remains to be done to improve the survival of patients with melanoma, clinically meaningful results seem within reach.
authors.affiliation: Division of Hematology, College of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
authors.forename: Svetomir N
authors.initials: SN
authors.lastname: Markovic
authors.forename: Lori A
authors.initials: LA
authors.lastname: Erickson
authors.forename: Ravi D
authors.initials: RD
authors.lastname: Rao
authors.forename: Roger H
authors.initials: RH
authors.lastname: Weenig
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Pockaj
authors.forename: Aditya
authors.initials: A
authors.lastname: Bardia
authors.forename: Celine M
authors.initials: CM
authors.lastname: Vachon
authors.forename: Steven E
authors.initials: SE
authors.lastname: Schild
authors.forename: Robert R
authors.initials: RR
authors.lastname: McWilliams
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Hand
authors.forename: Susan D
authors.initials: SD
authors.lastname: Laman
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Kottschade
authors.forename: William J
authors.initials: WJ
authors.lastname: Maples
authors.forename: Mark R
authors.initials: MR
authors.lastname: Pittelkow
authors.forename: Jose S
authors.initials: JS
authors.lastname: Pulido
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Cameron
authors.forename: Edward T
authors.initials: ET
authors.lastname: Creagan
mesh_terms: D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008545:Melanoma / Q000473:pathology* / Q000628:therapy*; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012878:Skin Neoplasms / Q000473:pathology* / Q000628:therapy*