title: [Detection of residual microscopic disease in melanoma: interest of the sentinel lymph node procedure?].
abstract: The prognosis of metastatic melanoma, despite many important and recent progresses, remains poor. The detection of microscopic disease must be a key point in fundamental and clinical research. Current recommendations, with clinical and radiological monitoring, only permit to detect macroscopic relapses. No seric tumor marker is presently sufficiently reproducible and determinant to be used in clinical practice to precociously diagnose a relapse. The sentinel lymph node procedure is currently the only technique largely used to determine microscopic metastasis. This technique allows defining a group of patients with poor prognosis but its therapeutic impact remains discussed. Completion lymph node dissection of the area after positive sentinel lymph node is currently performed but its real benefit to improve overall survival must be proved. Interferon is now the only treatment approved in adjuvant setting, but its interest remains discussed. Therapeutic trials are ongoing to really identify patients who could benefit from adjuvant treatment with interferon. Other trials probably more attractive (anti-CTLA4, BRAF and MEK inhibitors), with molecules recently approved in metastatic phase are also ongoing.
authors.affiliation: Université Paris-Sud, Service de dermatologie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Mateus
authors.affiliation: Université Paris-Sud, Service de dermatologie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
authors.forename: Marina
authors.initials: M
authors.lastname: Thomas
authors.affiliation: Université Paris-Sud, Service de dermatologie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Robert
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D017024:Chemotherapy, Adjuvant; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008545:Melanoma / Q000097:blood / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000556:secondary*; D061206:Neoplasm Micrometastasis / Q000473:pathology*; D018365:Neoplasm, Residual; D011379:Prognosis; D009418:S100 Proteins / Q000097:blood; D021701:Sentinel Lymph Node Biopsy / Q000401:mortality
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D009418:S100 Proteins; D007372:Interferons
keywords: adjuvant treatment; melanoma; sentinel lymph node