New paradigm for stage III melanoma: from surgery to adjuvant treatment

Journal of Translational Medicine

Pietro Quaglino¹  Roberto Patuzzo²  Corrado Caracò³  Gerardo Botti³  Paolo Muto³  Paolo Marchetti⁴  Lorenzo Borgognoni⁵  Ignazio Stanganelli⁶  Simone Mocellin⁷  Michele Guida⁸  Paolo Antonio Ascierto⁹  Giuseppe Palmieri^1,10 

[1] Dermatologic Clinic, Department of Medical Sciences, University of Turin Medical School;IRCCS Fondazione Istituto Nazionale dei Tumori di Milano;Istituto Nazionale Tumori IRCCS Fondazione “G. Pascale”;Oncologia Medica B Policlinico Umberto I di Roma;Ospedale Santa Maria Annunziata and University of Florence;Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS;Surgical Oncology Unit, IOV-IRCCS of Padova and Dept. Surgery Oncology Gastroenterology, University of Padova;Unit Melanoma and Rare Tumors, IRCCS Istituto Tumori Giovanni Paolo II;Unit Melanoma, Cancer Immunotherapy and Innovative Therapies, Istituto Nazionale Tumori IRCCS Fondazione “G. Pascale”;Unit of Cancer Genetics, ICB-CNR;

关键词: Staging;    Surgery;    Adjuvant treatment;    Melanoma;    Lymph node dissection;   

DOI  :  10.1186/s12967-019-2012-2

来源: DOAJ

【 摘 要 】

Abstract Background Recently the 8th version of the American Joint Committee on Cancer (AJCC) classification has been introduced, and has attempted to define a more accurate and precise definition of prognosis in line with the major progresses in understanding the biology and pathogenesis of melanoma. This new staging system introduces major changes in the stage III staging system. Indeed, surgical practice is changing in stage III patients, since, according to recent evidence, there is no survival benefit in radical lymph node dissection following a positive sentinel lymph node dissection. Therefore, some patients currently staged IIIB-C after dissection could be downgraded to IIIA (as in the case of patients with metastatic non-sentinel lymph nodes) since many completion lymph node dissections will no longer be performed. Moreover, new and effective targeted and immune strategies are being introduced in the pharmacological armamentarium in the adjuvant setting, showing major efficacy. Conclusions This article provides the authors’ personal view on the above-mentioned topics.

【 授权许可】

Unknown