title: Metastatic pathways in patients with cutaneous melanoma.
abstract: Metastasis represents the end product of an elaborate biological process, which is determined by a complex interplay between metastatic tumour cells, host factors and homoeostatic mechanisms. Cutaneous melanoma can metastasize haematogenously or lymphogenously. The three predominant models that endeavour to explain the patterns of melanoma progression are the stepwise spread model, the simultaneous spread model and the model of differential spread. The time course to the development of metastases differs between the different metastatic routes. There are several clinical and histopathological risk factors for the different metastatic pathways. In particular, patient sex and the anatomical location of the primary tumour influence patterns of disease progression. There is limited existing evidence regarding the relationship between tumour mutation status, other diagnostic and prognostic biomarkers and the metastatic pathways of primary cutaneous melanoma. This knowledge gap needs to be addressed to better identify patients at high risk of disease recurrence and personalize surveillance strategies.
authors.affiliation: Victorian Melanoma Service, Alfred Hospital, Melbourne, Vic, Australia.|School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Vic, Australia.
authors.forename: Nikki R
authors.initials: NR
authors.lastname: Adler
authors.affiliation: Victorian Melanoma Service, Alfred Hospital, Melbourne, Vic, Australia.|Department of Medical Oncology, Alfred Hospital, Melbourne, Vic, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Haydon
authors.affiliation: Department of Anatomical Pathology, Alfred Hospital, Melbourne, Vic, Australia.
authors.forename: Catriona A
authors.initials: CA
authors.lastname: McLean
authors.affiliation: Victorian Melanoma Service, Alfred Hospital, Melbourne, Vic, Australia.
authors.forename: John W
authors.initials: JW
authors.lastname: Kelly
authors.affiliation: Victorian Melanoma Service, Alfred Hospital, Melbourne, Vic, Australia.|School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Vic, Australia.|Skin and Cancer Foundation, Carlton, Vic, Australia.
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Mar
mesh_terms: D018450:Disease Progression; D006801:Humans; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000473:pathology*; D011379:Prognosis; D012878:Skin Neoplasms / Q000556:secondary*
keywords: biomarker; cutaneous melanoma; metastasis; metastatic pathways