Melanoma
- Villalobos León, María Laura
- Molina Villaverde, Raquel
- López González, José Luis
- Álvarez de Mon Soto, Melchor
ISSN: 0304-5412
Année de publication: 2013
Titre de la publication: Enfermedades oncológicas (III): tumores genitourinarios, melanoma
Serie: 11
Número: 26
Pages: 1597-1607
Type: Article
D'autres publications dans: Medicine: Programa de Formación Médica Continuada Acreditado
Résumé
The incidence of melanoma continues to increase dramatically. As with nearly all malignancies, the outcome of melanoma initially depends on the stage at presentation. The likelihood of regional nodal involvement increases with increased tumor thickness. Long term survival in patients with distant metastases is less than 10%. Wide excision and sentinel Iymph node biopsy are the most important part of the initial treatment. Most guidelines recommend adjuvant high-dose interferon for patients with stage IIB to 111. Resection, if feasible, is recommended for limited metastatic disease. Palliative radiotherapy should be considered, especially for symptomatic brain or localized and painful bone metastases. Traditional chemotherapy has demonstrated modest response rates under 20% in first-line and second-line settings. Two new approaches have changed treatment of metastatic disease: immunotherapy with ipilimumab, and vemurafenib if BRAF mutation is documented. These drugs have substantially improved response rates and/or survival of the patient population included in prospective randomized trials.