Management of in‐transit melanoma metastases: a review

Tie, Emilia Nan; Henderson, Michael A.; Gyorki, David E.

doi:10.1111/ans.14921

Cited by 21 publications

(10 citation statements)

References 43 publications

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“…If left untreated, these lesions grow, bleed, fungate, and smell. 80 In patients with minimal disease, surgical excision with pathologic clearance can be performed, but recurrence is common. 81 With a large number of lesions, and especially when distant disease is also present, a nonsurgical approach may be preferable.…”

Section: Minimally Invasive In-transit Management 501ementioning

confidence: 99%

Current Controversies in Melanoma Treatment

Temple‐Oberle¹,

Nicholas²,

Rojas-García³

2023

Plastic &Amp; Reconstructive Surgery

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Learning Objectives: After reading this article and viewing the videos, the participant should be able to: 1. Discuss margins for in situ and invasive disease and describe reconstructive options for wide excision defects, including the keystone flap. 2. Describe a digit-sparing alternative for subungual melanoma. 3. Calculate personalized risk estimates for sentinel node biopsy using predictive nomograms. 4. Describe the indications for lymphadenectomy and describe a technique intended to reduce the risk of lymphedema following lymphadenectomy. 5. Offer options for in-transit melanoma management. Summary: Melanoma management continues to evolve, and plastic surgeons need to stay at the forefront of advances and controversies. Appropriate margins for in situ and invasive disease require consideration of the trials on which they are based. A workhorse reconstruction option for wide excision defects, particularly in extremities, is the keystone flap. There are alternative surgical approaches to subungual tumors besides amputation. It is now possible to personalize a risk estimate for sentinel node positivity beyond what is available for groups of patients with a given stage of disease. Sentinel node biopsy can be made more accurate and less morbid with novel adjuncts. Positive sentinel node biopsies are now rarely managed with completion lymphadenectomy. Should a patient require lymphadenectomy, immediate lymphatic reconstruction may mitigate the lymphedema risk. Finally, there are minimally invasive modalities for effective control of in-transit recurrences.

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Section: Minimally Invasive In-transit Management 501ementioning

confidence: 99%

Current Controversies in Melanoma Treatment

Temple‐Oberle¹,

Nicholas²,

Rojas-García³

2023

Plastic &Amp; Reconstructive Surgery

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“…The treatment and management of melanoma may vary with its stage, which is classified depending on the tumor thickness, ulceration, depth, nodal status, and the presence of metastasis [ 1 , 6 ]. The primary treatment for the early stage of the disease is the complete resection of the tumor with a wide surgical margin [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Pluronic F-127 Hydrogels Containing Copper Oxide Nanoparticles and a Nitric Oxide Donor to Treat Skin Cancer

et al. 2023

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Melanoma is a serious and aggressive type of skin cancer with growing incidence, and it is the leading cause of death among those affected by this disease. Although surgical resection has been employed as a first-line treatment for the early stages of the tumor, noninvasive topical treatments might represent an alternative option. However, they can be irritating to the skin and result in undesirable side effects. In this context, the potential of topical polymeric hydrogels has been investigated for biomedical applications to overcome current limitations. Due to their biocompatible properties, hydrogels have been considered ideal candidates to improve local therapy and promote wound repair. Moreover, drug combinations incorporated into the polymeric-based matrix have emerged as a promising approach to improve the efficacy of cancer therapy, making them suitable vehicles for drug delivery. In this work, we demonstrate the synthesis and characterization of Pluronic F-127 hydrogels (PL) containing the nitric oxide donor S-nitrosoglutathione (GSNO) and copper oxide nanoparticles (CuO NPs) against melanoma cells. Individually applied NO donor or metallic oxide nanoparticles have been widely explored against various types of cancer with encouraging results. This is the first report to assess the potential and possible underlying mechanisms of action of PL containing both NO donor and CuO NPs toward cancer cells. We found that PL + GSNO + CuO NPs significantly reduced cell viability and greatly increased the levels of reactive oxygen species. In addition, this novel platform had a huge impact on different organelles, thus triggering cell death by inducing nuclear changes, a loss of mitochondrial membrane potential, and lipid peroxidation. Thus, GSNO and CuO NPs incorporated into PL hydrogels might find important applications in the treatment of skin cancer.

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“…They occur more frequently in the lower limbs, due to the greater lymphatic stasis due to gravity or following a lymphadenectomy, and a longer lymphatic network that leads the cancer cells to accumulate more. Conversely, distant cutaneous metastasis can spread both through multiple lymphatic basins, as occurs in primary trunk melanoma, and through blood vessels [ 1 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Surgical excision is generally considered first-line therapy when possible. Local therapies (including electrochemotherapy (ECT), intralesional injection, isolated limb infusion (ILI) or perfusion (ILP), carbon dioxide laser ablation, cryotherapy, radiotherapy (RT), and topical therapy) or systemic immunotherapies and/or targeted therapies play a role when surgery is not appropriate [ 4 , 6 , 7 , 8 ]…”

Section: Introductionmentioning

confidence: 99%

Radiotherapy in the Treatment of Subcutaneous Melanoma

Borzillo

Muto

2021

Cancers

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Malignant melanoma frequently develops cutaneous and/or subcutaneous metastases during the course of the disease. These may present as non-nodal locoregional metastases (microsatellite, satellite, or in-transit) included in stage III or as distant metastases in stage IV. Their presentation is heterogeneous and associated with significant morbidity resulting from both disease-related functional damage and treatment side effects. The standard treatment is surgical excision, whereas local therapies or systemic therapies have a role when surgery is not indicated. Radiotherapy can be used in the local management of ITM, subcutaneous relapses, or distant metastases to provide symptom relief and prolong regional disease control. To increase the local response without increasing toxicity, the addition of hyperthermia and intralesional therapies to radiotherapy appear to be very promising. Boron neutron capture therapy, based on nuclear neutron capture and boron isotope fission reaction, could be an alternative to standard treatments, but its use in clinical practice is still limited. The potential benefit of combining radiotherapy with targeted therapies and immunotherapy has yet to be explored in this lesion setting. This review explores the role of radiotherapy in the treatment of cutaneous and subcutaneous lesions, its impact on outcomes, and its association with other treatment modalities.

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Management of in‐transit melanoma metastases: a review

Cited by 21 publications

References 43 publications

Current Controversies in Melanoma Treatment

Current Controversies in Melanoma Treatment

Pluronic F-127 Hydrogels Containing Copper Oxide Nanoparticles and a Nitric Oxide Donor to Treat Skin Cancer

Radiotherapy in the Treatment of Subcutaneous Melanoma

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