Guidelines of care for the management of primary cutaneous melanoma

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:80

Article

Swetter, Susan M.^1,2,3  Tsao, Hensin^4,5,6  Bichakjian, Christopher K.^7,8  Curiel-Lewandrowski, Clara^9,10  Elder, David E.^11,12  Gershenwald, Jeffrey E.^13,14  Guild, Valerie¹⁵  Grant-Kels, Jane M.^16,17,18  Halpern, Allan C.¹⁹  Johnson, Timothy M.^7,8  Sober, Arthur J.^4,5  Thompson, John A.^20,21  Wisco, Oliver J.²²  Wyatt, Samantha²³  Hu, Shasa²⁴  Lamina, Toyin²⁵ 

[1] Stanford Univ, Med Ctr, Dept Dermatol, Stanford, CA 94305 USA

[2] Canc Inst, Stanford, CA USA

[3] Vet Affairs Palo Alto Hlth Care Syst, Palo Alto, CA USA

[4] Massachusetts Gen Hosp, Dept Dermatol, Boston, MA 02114 USA

[5] Harvard Med Sch, Boston, MA USA

[6] Wellman Ctr Photomed, Boston, MA USA

[7] Univ Michigan Hlth Syst, Dept Dermatol, Ann Arbor, MI USA

[8] Comprehens Canc Ctr, Ann Arbor, MI USA

[9] Univ Arizona, Div Dermatol, Tucson, AZ USA

[10] Univ Arizona, Ctr Canc, Tucson, AZ USA

[11] Hosp Univ Penn, Dept Dermatol, Philadelphia, PA 19104 USA

[12] Hosp Univ Penn, Dept Pathol, Philadelphia, PA 19104 USA

[13] Univ Texas MD Anderson Canc Ctr, Dept Surg Oncol, Houston, TX 77030 USA

[14] Univ Texas MD Anderson Canc Ctr, Dept Canc Biol, Houston, TX 77030 USA

[15] Melanoma Fdn, AIM, Plano, TX USA

[16] Univ Connecticut, Ctr Hlth, Dept Dermatol, Farmington, CT USA

[17] Univ Connecticut, Ctr Hlth, Dept Pathol, Farmington, CT USA

[18] Univ Connecticut, Ctr Hlth, Dept Pediat, Farmington, CT USA

[19] Mem Sloan Kettering Canc Ctr, Dept Dermatol, 1275 York Ave, New York, NY 10021 USA

[20] Univ Washington, Div Oncol, Seattle, WA 98195 USA

[21] Seattle Canc Care Alliance, Washington, DC USA

[22] Oregon Hlth & Sci Univ, Dept Dermatol, Portland, OR 97201 USA

[23] Univ Miami Hlth Syst, Dermatol, Miami, FL USA

[24] Univ Miami Hlth Syst, Dept Dermatol, Miami, FL USA

[25] Amer Acad Dermatol, Rosemont, PA USA

关键词: biopsy;    follow-up;    genetic counseling;    imiquimod;    melanoma;    Mohs micrographic surgery;    molecular techniques;    pathology report;    pregnancy;    nonsurgical techniques;    radiation therapy;    sentinel lymph node biopsy;    skin toxicities;    surgical margins;    staged excision;    treatment;   

DOI  :  10.1016/j.jaad.2018.08.055

来源: Elsevier

【 摘 要 】

The incidence of primary cutaneous melanoma continues to increase each year. Melanoma accounts for the majority of skin cancererelated deaths, but treatment is usually curative following early detection of disease. In this American Academy of Dermatology clinical practice guideline, updated treatment recommendations are provided for patients with primary cutaneous melanoma (American Joint Committee on Cancer stages 0-IIC and pathologic stage III by virtue of a positive sentinel lymph node biopsy). Biopsy techniques for a lesion that is clinically suggestive of melanoma are reviewed, as are recommendations for the histopathologic interpretation of cutaneous melanoma. The use of laboratory, molecular, and imaging tests is examined in the initial work-up of patients with newly diagnosed melanoma and for follow-up of asymptomatic patients. With regard to treatment of primary cutaneous melanoma, recommendations for surgical margins and the concepts of staged excision (including Mohs micrographic surgery) and nonsurgical treatments for melanoma in situ, lentigo maligna type (including topical imiquimod and radiation therapy), are updated. The role of sentinel lymph node biopsy as a staging technique for cutaneous melanoma is described, with recommendations for its use in clinical practice. Finally, current data regarding pregnancy and melanoma, genetic testing for familial melanoma, and management of dermatologic toxicities related to novel targeted agents and immunotherapies for patients with advanced disease are summarized.

【 授权许可】

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