title: Diagnostic and therapeutic approaches in Italian hospitals: adjuvant and metastatic therapy in melanoma.
abstract: Melanoma incidence and mortality rates are rising in Italy, indicating that more effective treatments are required both in the adjuvant and metastatic settings. We analyzed clinical practices in the adjuvant and metastatic settings by conducting a nationwide survey of clinicians responsible for managing melanoma treatment and follow-up in a representative sample of Italian hospitals. 95% of participating hospitals completed the panel of questions on adjuvant and metastatic treatment, making it likely that these results give a realistic picture of treatment and follow-up of melanoma patients in Italy. In low-volume hospitals (<25 new melanoma diagnoses yearly) adjuvant therapy was significantly more used than in large-volume hospitals for patients in stage III and IV (82 versus 66% and 56 versus 30%, respectively), and only 11% of patients were enrolled in clinical trials. In the metastatic setting dacarbazine was the preferred first-line treatment (32%) followed by polychemotherapy (23%); 12% of patients were enrolled in clinical trials and less than 10% received interleukin-2, usually subcutaneously. The information provided by this study was used by the Italian Melanoma Intergroup to improve the quality of care and to redirect financial resources.
authors.affiliation: Melanoma and Skin Cancer Unit, Veneto Oncology Institute, IRCCS, Padua, Italy. mgaliz @ tiscali.it
authors.forename: Vanna
authors.initials: V
authors.lastname: Chiarion-Sileni
authors.forename: Michele
authors.initials: M
authors.lastname: Guida
authors.forename: Antonella
authors.initials: A
authors.lastname: Romanini
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Bernengo
authors.forename: Paolo
authors.initials: P
authors.lastname: Ascierto
authors.forename: Paola
authors.initials: P
authors.lastname: Queirolo
authors.forename: Mario
authors.initials: M
authors.lastname: Mandalà
authors.forename: Michele
authors.initials: M
authors.lastname: Maio
authors.forename: Virginia
authors.initials: V
authors.lastname: Ferraresi
authors.forename: Ignazio
authors.initials: I
authors.lastname: Stanganelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Testori
authors.forename: Ruggero
authors.initials: R
authors.lastname: Ridolfi
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003131:Combined Modality Therapy / Q000379:methods; D006306:Health Surveys; D061847:Hospitals, High-Volume / Q000706:statistics & numerical data; D061846:Hospitals, Low-Volume / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy; D008495:Medical Oncology / Q000592:standards*; D008545:Melanoma / Q000175:diagnosis* / Q000628:therapy*; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents