Baseline staging in cutaneous malignant melanoma

Abstract

The combination of physical examination and lymph node US detects the great majority of patients with macroscopic lymph node metastasis (approximately 3% of patients at baseline). Only 10% of patients who have a histologically tumour-positive sentinel node are macroscopically detectable. Altogether, approximately 25% of patients have a positive sentinel node biopsy, among 90% microscopic. The value of whole body staging at baseline remains limited, since distant metastases can hardly ever be detected. The survival benefit of baseline staging and surveillance in patients with cutaneous MM remains to be established by comparative prospective trials.

The influence of sentinel lymph node tumour burden on additional lymph node involvement and disease-free survival in cutaneous melanoma – a retrospective analysis of 392 cases

“…All patients underwent WE wide excision of the primary tumour with a safety margin of 1 cm for Breslow thickness below 2 mm and a safety margin of 2 cm for Breslow thickness above 2 mm, in accordance with Swiss guidelines (Dummer et al, 2005). Neither the triple technique used to identify and remove the SLNs nor the methodology employed for pathological analysis of the removed lymph nodes differs from that previously described in the literature (Hafner et al, 2004;Morton et al, 2005). Consistent with published guidelines (Cochran et al, 2000), SLNB was recommended for pathological staging of the RLN in patients with a minimal Breslow of 1.00 mm and no clinical or radiological evidence of melanoma metastasis at the time of diagnosis.…”

“…On the basis of the concept that the regional lymphatics serve as a barrier, temporarily trapping the orderly tumour spread from the primary site to more distant locations, it was proposed that the histopathological status of the SLN would accurately predict melanoma metastases (Reintgen et al, 1994;Thompson et al, 1995). Today, SNB is the most important staging tool, because the status of the SLN represents the most important prognostic factor for recurrence and survival for melanoma patients and identifies patients who might benefit from further therapy, such as completion lymph node dissection (CLND) and adjuvant interferon therapy (Morton et al, 1999;Balch et al, 2001;Hafner et al, 2004;Eggermont et al, 2007).…”

Efeitos antiproliferativos e apoptóticos da fosfoetanolamina sintética no melanoma B16F10

“…Em mamíferos, estão presentes na camada basal da epiderme, nos folículos pilosos, na derme, na retina e íris. Na pele, os melanossomos (organelas que contém melanina produzida nos melanócitos são transferidas para os queratinócitos vizinhos por um mecanismo ainda não totalmente esclarecido, mas que parece envolver a fagocitose da ponta dos processos dendriticos dos melanócitos pelos queratinócitos) 5,6,7 .…”

Comparison between 18F-FDG PET (PET/CT) and sentinel lymph node biopsy in the detection of regional lymph node metastasis of various malignancies: review of the literature

“…Hafner et al [35] studied 100 consecutive patients with malignant melanoma with a Breslow tumor thickness > 1.0 mm. The sensitivity and specificity of SLNB and 18 F-FDG PET were evaluated with regard to the early detection of regional lymph node metastasis.…”