Malignant melanoma in the 21st century, part 2: staging, prognosis, and treatment.
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.
Markovic
Svetomir N
SN
Division of Hematology, College of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Erickson
Lori A
LA
Rao
Ravi D
RD
Weenig
Roger H
RH
Pockaj
Barbara A
BA
Bardia
Aditya
A
Vachon
Celine M
CM
Schild
Steven E
SE
McWilliams
Robert R
RR
Hand
Jennifer L
JL
Laman
Susan D
SD
Kottschade
Lisa A
LA
Maples
William J
WJ
Pittelkow
Mark R
MR
Pulido
Jose S
JS
Cameron
J Douglas
JD
Creagan
Edward T
ET
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*