ABSTRACT
Metastatic malignant melanoma is an incurable malignancy with extremely poor prognosis. Patients bearing this diagnosis face a median survival time of approximately 9 months with a probability of surviving 5 years after initial presentation at less than 5%. This is contrasted by the curative nature of surgical resection of early melanoma detected in the skin. To date, no systemic therapy has consistently and predictably impacted the overall survival of patients with metastatic melanoma. However, in recent years, a resurgence of innovative diagnostic and therapeutic developments have broadened our understanding of the natural history of melanoma and identified rational therapeutic targets/strategies that seem poised to significantly change the clinical outcomes in these patients. Herein we review the state-of-the-art in metastatic melanoma diagnostics and therapeutics with particular emphasis on multi-disciplinary clinical management.
Subject(s)
Melanoma/secondary , Melanoma/therapy , Skin Neoplasms/pathology , Skin Neoplasms/therapy , Antineoplastic Agents/therapeutic use , Chemotherapy, Adjuvant , Diagnosis, Differential , Evidence-Based Medicine , Fluorodeoxyglucose F18 , Humans , Immunotherapy , Magnetic Resonance Imaging , Melanoma/diagnosis , Melanoma/drug therapy , Melanoma/mortality , Melanoma/radiotherapy , Melanoma/surgery , Positron-Emission Tomography , Prognosis , Radiotherapy, Adjuvant , Skin Neoplasms/diagnosis , Skin Neoplasms/drug therapy , Skin Neoplasms/mortality , Skin Neoplasms/radiotherapy , Skin Neoplasms/surgery , Survival Analysis , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
As a result of increased accuracy of staging and decreased patient morbidity, lymphatic mapping and sentinel lymph node (SLN) biopsy for breast cancer has enjoyed a rapid acceptance into clinical practice. Despite the use of lymphatic mapping techniques to obtain nodal staging information, many controversies remain. We have attempted to highlight the major controversies in this report.
