Surgery and radiotherapy in the treatment of cutaneous melanoma
Identifieur interne : 003B09 ( Pmc/Curation ); précédent : 003B08; suivant : 003B10Surgery and radiotherapy in the treatment of cutaneous melanoma
Auteurs : A. Testori [Italie] ; P. Rutkowski [Pologne] ; J. Marsden [Royaume-Uni] ; L. Bastholt [Danemark] ; V. Chiarion-Sileni [Italie] ; A. Hauschild [Allemagne] ; A. M. M. Eggermont [Pays-Bas]Source :
- Annals of Oncology [ 0923-7534 ] ; 2009.
Abstract
Adequate surgical management of primary melanoma and regional lymph node metastasis, and rarely distant metastasis, is the only established curative treatment. Surgical management of primary melanomas consists of excisions with 1–2 cm margins and primary closure. The recommended method of biopsy is excisional biopsy with a 2 mm margin and a small amount of subcutaneous fat. In specific situations (very large lesions or certain anatomical areas), full-thickness incisional or punch biopsy may be acceptable. Sentinel lymph node biopsy provides accurate staging information for patients with clinically unaffected regional nodes and without distant metastases, although survival benefit has not been proved. In cases of positive sentinel node biopsy or clinically detected regional nodal metastases (palpable, positive cytology or histopathology), radical removal of lymph nodes of the involved basin is indicated. For resectable local/in-transit recurrences, excision with a clear margin is recommended. For numerous or unresectable in-transit metastases of the extremities, isolated limb perfusion or infusion with melphalan should be considered. Decisions about surgery of distant metastases should be based on individual circumstances. Radiotherapy is indicated as a treatment option in select patients with lentigo maligna melanoma and as an adjuvant in select patients with regional metastatic disease. Radiotherapy is also indicated for palliation, especially in bone and brain metastases.
Url:
DOI: 10.1093/annonc/mdp257
PubMed: 19617294
PubMed Central: 2712595
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Surgery and radiotherapy in the treatment of cutaneous melanoma</title><author><name sortKey="Testori, A" sort="Testori, A" uniqKey="Testori A" first="A." last="Testori">A. Testori</name><affiliation wicri:level="1"><nlm:aff id="aff1">European Institute of Oncology, Division of Melanoma, Milan, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>European Institute of Oncology, Division of Melanoma, Milan</wicri:regionArea></affiliation></author><author><name sortKey="Rutkowski, P" sort="Rutkowski, P" uniqKey="Rutkowski P" first="P." last="Rutkowski">P. Rutkowski</name><affiliation wicri:level="1"><nlm:aff id="aff2">M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Department of Soft Tissue/Bone Sarcoma and Melanoma, Warsaw, Poland</nlm:aff><country xml:lang="fr">Pologne</country><wicri:regionArea>M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Department of Soft Tissue/Bone Sarcoma and Melanoma, Warsaw</wicri:regionArea></affiliation></author><author><name sortKey="Marsden, J" sort="Marsden, J" uniqKey="Marsden J" first="J." last="Marsden">J. Marsden</name><affiliation wicri:level="1"><nlm:aff id="aff3">University Hospital Birmingham, Birmingham, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University Hospital Birmingham, Birmingham</wicri:regionArea></affiliation></author><author><name sortKey="Bastholt, L" sort="Bastholt, L" uniqKey="Bastholt L" first="L." last="Bastholt">L. Bastholt</name><affiliation wicri:level="1"><nlm:aff id="aff4">Department of Oncology, Odense University Hospital, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Oncology, Odense University Hospital</wicri:regionArea></affiliation></author><author><name sortKey="Chiarion Sileni, V" sort="Chiarion Sileni, V" uniqKey="Chiarion Sileni V" first="V." last="Chiarion-Sileni">V. Chiarion-Sileni</name><affiliation wicri:level="1"><nlm:aff id="aff5">Medical Oncology Unit, Istituto Oncologico Veneto–IRCCS, Padova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Medical Oncology Unit, Istituto Oncologico Veneto–IRCCS, Padova</wicri:regionArea></affiliation></author><author><name sortKey="Hauschild, A" sort="Hauschild, A" uniqKey="Hauschild A" first="A." last="Hauschild">A. 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Eggermont</name><affiliation wicri:level="1"><nlm:aff id="aff7">Erasmus University Medical Center–Daniel den Hoed Cancer Center, Department of Surgical Oncology; Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Erasmus University Medical Center–Daniel den Hoed Cancer Center, Department of Surgical Oncology; Rotterdam</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19617294</idno><idno type="pmc">2712595</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2712595</idno><idno type="RBID">PMC:2712595</idno><idno type="doi">10.1093/annonc/mdp257</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">003B10</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003B10</idno><idno type="wicri:Area/Pmc/Curation">003B09</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">003B09</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Surgery and radiotherapy in the treatment of cutaneous melanoma</title><author><name sortKey="Testori, A" sort="Testori, A" uniqKey="Testori A" first="A." last="Testori">A. Testori</name><affiliation wicri:level="1"><nlm:aff id="aff1">European Institute of Oncology, Division of Melanoma, Milan, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>European Institute of Oncology, Division of Melanoma, Milan</wicri:regionArea></affiliation></author><author><name sortKey="Rutkowski, P" sort="Rutkowski, P" uniqKey="Rutkowski P" first="P." last="Rutkowski">P. Rutkowski</name><affiliation wicri:level="1"><nlm:aff id="aff2">M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Department of Soft Tissue/Bone Sarcoma and Melanoma, Warsaw, Poland</nlm:aff><country xml:lang="fr">Pologne</country><wicri:regionArea>M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Department of Soft Tissue/Bone Sarcoma and Melanoma, Warsaw</wicri:regionArea></affiliation></author><author><name sortKey="Marsden, J" sort="Marsden, J" uniqKey="Marsden J" first="J." last="Marsden">J. Marsden</name><affiliation wicri:level="1"><nlm:aff id="aff3">University Hospital Birmingham, Birmingham, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University Hospital Birmingham, Birmingham</wicri:regionArea></affiliation></author><author><name sortKey="Bastholt, L" sort="Bastholt, L" uniqKey="Bastholt L" first="L." last="Bastholt">L. Bastholt</name><affiliation wicri:level="1"><nlm:aff id="aff4">Department of Oncology, Odense University Hospital, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Oncology, Odense University Hospital</wicri:regionArea></affiliation></author><author><name sortKey="Chiarion Sileni, V" sort="Chiarion Sileni, V" uniqKey="Chiarion Sileni V" first="V." last="Chiarion-Sileni">V. Chiarion-Sileni</name><affiliation wicri:level="1"><nlm:aff id="aff5">Medical Oncology Unit, Istituto Oncologico Veneto–IRCCS, Padova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Medical Oncology Unit, Istituto Oncologico Veneto–IRCCS, Padova</wicri:regionArea></affiliation></author><author><name sortKey="Hauschild, A" sort="Hauschild, A" uniqKey="Hauschild A" first="A." last="Hauschild">A. Hauschild</name><affiliation wicri:level="1"><nlm:aff id="aff6">Department of Dermatology, University of Kiel, Kiel, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Dermatology, University of Kiel, Kiel</wicri:regionArea></affiliation></author><author><name sortKey="Eggermont, A M M" sort="Eggermont, A M M" uniqKey="Eggermont A" first="A. M. M." last="Eggermont">A. M. M. Eggermont</name><affiliation wicri:level="1"><nlm:aff id="aff7">Erasmus University Medical Center–Daniel den Hoed Cancer Center, Department of Surgical Oncology; Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Erasmus University Medical Center–Daniel den Hoed Cancer Center, Department of Surgical Oncology; Rotterdam</wicri:regionArea></affiliation></author></analytic><series><title level="j">Annals of Oncology</title><idno type="ISSN">0923-7534</idno><idno type="eISSN">1569-8041</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Adequate surgical management of primary melanoma and regional lymph node metastasis, and rarely distant metastasis, is the only established curative treatment. Surgical management of primary melanomas consists of excisions with 1–2 cm margins and primary closure. The recommended method of biopsy is excisional biopsy with a 2 mm margin and a small amount of subcutaneous fat. In specific situations (very large lesions or certain anatomical areas), full-thickness incisional or punch biopsy may be acceptable. Sentinel lymph node biopsy provides accurate staging information for patients with clinically unaffected regional nodes and without distant metastases, although survival benefit has not been proved. In cases of positive sentinel node biopsy or clinically detected regional nodal metastases (palpable, positive cytology or histopathology), radical removal of lymph nodes of the involved basin is indicated. For resectable local/in-transit recurrences, excision with a clear margin is recommended. For numerous or unresectable in-transit metastases of the extremities, isolated limb perfusion or infusion with melphalan should be considered. Decisions about surgery of distant metastases should be based on individual circumstances. Radiotherapy is indicated as a treatment option in select patients with lentigo maligna melanoma and as an adjuvant in select patients with regional metastatic disease. Radiotherapy is also indicated for palliation, especially in bone and brain metastases.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Salopek, Tg" uniqKey="Salopek T">TG Salopek</name></author><author><name sortKey="Slade, J" uniqKey="Slade J">J Slade</name></author><author><name sortKey="Marghoob, Aa" uniqKey="Marghoob A">AA Marghoob</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Argenziano, G" uniqKey="Argenziano G">G Argenziano</name></author><author><name sortKey="Soyer, Hp" uniqKey="Soyer H">HP Soyer</name></author><author><name sortKey="Chimenti, S" uniqKey="Chimenti S">S Chimenti</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Attis, Mg" uniqKey="Attis M">MG Attis</name></author><author><name sortKey="Vollmer, Rt" uniqKey="Vollmer R">RT Vollmer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gimotty, Pa" 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Oncol</journal-id><journal-id journal-id-type="iso-abbrev">Ann. Oncol</journal-id><journal-id journal-id-type="hwp">annonc</journal-id><journal-id journal-id-type="publisher-id">annonc</journal-id><journal-title-group><journal-title>Annals of Oncology</journal-title></journal-title-group><issn pub-type="ppub">0923-7534</issn><issn pub-type="epub">1569-8041</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">19617294</article-id><article-id pub-id-type="pmc">2712595</article-id><article-id pub-id-type="doi">10.1093/annonc/mdp257</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>Surgery and radiotherapy in the treatment of cutaneous melanoma</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Testori</surname><given-names>A.</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Rutkowski</surname><given-names>P.</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Marsden</surname><given-names>J.</given-names></name><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Bastholt</surname><given-names>L.</given-names></name><xref ref-type="aff" rid="aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Chiarion-Sileni</surname><given-names>V.</given-names></name><xref ref-type="aff" rid="aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Hauschild</surname><given-names>A.</given-names></name><xref ref-type="aff" rid="aff6">6</xref></contrib><contrib contrib-type="author"><name><surname>Eggermont</surname><given-names>A. M. M.</given-names></name><xref ref-type="aff" rid="aff7">7</xref></contrib></contrib-group><aff id="aff1"><label>1</label>European Institute of Oncology, Division of Melanoma, Milan, Italy</aff><aff id="aff2"><label>2</label>M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Department of Soft Tissue/Bone Sarcoma and Melanoma, Warsaw, Poland</aff><aff id="aff3"><label>3</label>University Hospital Birmingham, Birmingham, UK</aff><aff id="aff4"><label>4</label>Department of Oncology, Odense University Hospital, Denmark</aff><aff id="aff5"><label>5</label>Medical Oncology Unit, Istituto Oncologico Veneto–IRCCS, Padova, Italy</aff><aff id="aff6"><label>6</label>Department of Dermatology, University of Kiel, Kiel, Germany</aff><aff id="aff7"><label>7</label>Erasmus University Medical Center–Daniel den Hoed Cancer Center, Department of Surgical Oncology; Rotterdam, The Netherlands</aff><author-notes><corresp id="cor1"><label>*</label><italic>Correspondence to</italic>: Alessandro Testori, European Institute of Oncology, Via Ripamonti 435, Milan, Italy 20141; Tel: +39-057489459493; Fax: +39-057489091; E-mail: <email>alessandro.testori@ieo.it</email></corresp></author-notes><pub-date pub-type="epub-ppub"><month>8</month><year>2009</year></pub-date><pmc-comment>Fake ppub date generated by PMC from publisher pub-date/@pub-type='epub-ppub' </pmc-comment>
<pub-date pub-type="ppub"><month>8</month><year>2009</year></pub-date><pub-date pub-type="pmc-release"><month>8</month><year>2009</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on the
<volume>20</volume><issue>Suppl 6</issue><issue-title>Melanoma: Perspectives of the Global Melanoma Task Force</issue-title><fpage>vi22</fpage><lpage>vi29</lpage><permissions><copyright-statement>© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.</copyright-statement><copyright-year>2009</copyright-year><license license-type="open-access"><license-p>The online version of this article has been published under an open access model. users are entitle to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and the European Society for Medical Oncology are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org</license-p></license></permissions><abstract><p>Adequate surgical management of primary melanoma and regional lymph node metastasis, and rarely distant metastasis, is the only established curative treatment. Surgical management of primary melanomas consists of excisions with 1–2 cm margins and primary closure. The recommended method of biopsy is excisional biopsy with a 2 mm margin and a small amount of subcutaneous fat. In specific situations (very large lesions or certain anatomical areas), full-thickness incisional or punch biopsy may be acceptable. Sentinel lymph node biopsy provides accurate staging information for patients with clinically unaffected regional nodes and without distant metastases, although survival benefit has not been proved. In cases of positive sentinel node biopsy or clinically detected regional nodal metastases (palpable, positive cytology or histopathology), radical removal of lymph nodes of the involved basin is indicated. For resectable local/in-transit recurrences, excision with a clear margin is recommended. For numerous or unresectable in-transit metastases of the extremities, isolated limb perfusion or infusion with melphalan should be considered. Decisions about surgery of distant metastases should be based on individual circumstances. Radiotherapy is indicated as a treatment option in select patients with lentigo maligna melanoma and as an adjuvant in select patients with regional metastatic disease. Radiotherapy is also indicated for palliation, especially in bone and brain metastases.</p></abstract><kwd-group><kwd>cutaneous melanoma</kwd><kwd>electrochemotherapy</kwd><kwd>limb perfusion</kwd><kwd>melanoma radiotherapy</kwd><kwd>melanoma surgery</kwd><kwd>sentinel node</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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