Melanoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Changes to This Summary (05 / 16 / 2013)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.General Information About MelanomaAdded Risk Factors as a new subsection.Cellular and Molecular Classification of MelanomaRevised text to state that identification of activating mutations in the mitogen-activated protein (MAP) kinase pathway has led to the definition of molecular subtypes of melanoma and provided potential drug targets. Treatment Option OverviewRevised text to state that prospective, randomized, controlled trials with both agents have not shown an increase in overall survival (OS) when compared with observation (cited Kirkwood et al. and Eggermont et al. as references 9 and 10, respectively.) Also added text about therapies that have impacted OS in patients with recurrent or metastatic disease that are now being tested as adjuvant therapy in clinical trials, including
Melanoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage II Melanoma
Stage II melanoma is defined by the American Joint Committee on Cancer's TNM classification system:T2b, N0, M0T3a, N0, M0T3b, N0, M0T4a, N0, M0T4b, N0, M0Standard Treatment Options for Patients With Stage II MelanomaCurrent evidence suggests that for melanomas with a thickness between 2 mm and 4 mm, the surgical margins need to be 2 cm or less. The Intergroup Melanoma Surgical Trial compared 2-cm margins versus 4-cm margins for patients with 1-mm thick melanomas to 4-mm thick melanomas. With a median follow-up of more than 10 years, no significant difference was observed between the two groups in terms of local recurrence or survival. The reduction in margins from 4 cm to 2 cm was associated with a statistically significant reduction in the need for skin grafting (46% to11%; P < .001) and a reduction in the length of the hospital stay. Depending on the location of the melanoma, most patients can now have this surgery performed on an outpatient basis. A study conducted in
Skin Cancer Screening (PDQ®): Screening - Patient Information [NCI] - What is screening?
Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early,it may be easier to treat. By the time symptoms appear,cancer may have begun to spread. Scientists are trying to better understand which people are more likely to get certain types of cancer. They also study the things we do and the ...
Melanoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage III Melanoma
Stage III melanoma is defined by the American Joint Committee on Cancer's TNM classification system:Any T, N1, M0Any T, N2, M0Any T, N3, M0Standard Treatment Options for Patients With Stage III MelanomaWide local excision of the primary tumor with 1 cm to 3 cm margins, depending on tumor thickness and location.[2,3,4,5,6,7,8] Skin grafting may be necessary to close the resulting defect.High-dose or pegylated interferon alpha-2b as adjuvant treatment for patients who have undergone a complete surgical resection but are considered to be at high risk for relapse.Ipilimumab for patients with unresectable disease.Vemurafenib for patients with unresectable disease who test positive for the BRAF V600 mutation in a U.S. Food and Drug Administration-approved test.Adjuvant Treatment Options for Patients With Resected Stage III DiseaseProspective, randomized, multicenter treatment trials have demonstrated that high-dose interferon alpha-2b and pegylated interferon do not improve overall
Intraocular (Uveal) Melanoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Recurrent Intraocular Melanoma
The prognosis for any patient with recurring or relapsing disease is poor, regardless of cell type or stage. The question and selection of further treatment depends on many factors, including the extent of the lesion, age and health of the patient, prior treatment, and site of recurrence, as well as individual patient considerations. Surgical resection of metastases diagnosed subsequent to initial management of ocular melanoma in single-center, case series of highly selected patients has been reported. The extent to which the occasional favorable outcomes are the result of strong selection factors is not clear, so this approach cannot be considered standard.Clinical trials are appropriate, and eligible patients should be advised to consider participation in them whenever possible. Current Clinical TrialsCheck for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent intraocular melanoma. The list of clinical trials can be
Metastatic Squamous Neck Cancer with Occult Primary Treatment (PDQ®): Treatment - Patient Information [NCI] - Recurrent Metastatic Squamous Neck Cancer with Occult Primary
Recurrent metastatic squamous neck cancer with occult primary is cancer that has recurred (come back) after it has been treated. The cancer may come back in the neck or other parts of the body.
Melanoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Treatment Option Overview
Melanomas that have not spread beyond the site at which they developed are highly curable. Most of these are thin lesions that have not invaded beyond the papillary dermis (Clark level I–II; Breslow thickness ≤1 mm). The treatment of localized melanoma is surgical excision with margins proportional to the microstage of the primary lesion; for most lesions 2 mm or less in thickness, this means 1 cm radial re-excision margins.[1,2]Melanomas with a Breslow thickness of 2 mm or more are still curable in a significant proportion of patients, but the risk of lymph node and/or systemic metastasis increases with increasing thickness of the primary lesion. The local treatment for these melanomas is surgical excision with margins based on Breslow thickness and anatomic location. For most melanomas more than 2 mm to 4 mm in thickness, this means 2 cm to 3 cm radial excision margins. These patients should also be considered for sentinel lymph node biopsy followed by complete lymph node
Skin Cancer Screening (PDQ®): Screening - Patient Information [NCI] - Questions or Comments About This Summary
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Intraocular (Uveal) Melanoma Treatment (PDQ®): Treatment - Patient Information [NCI] - nci_ncicdr0000258015-nci-header
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.Intraocular (Eye) Melanoma Treatment
Skin Cancer Treatment (PDQ®): Treatment - Patient Information [NCI] - Changes to This Summary (05 / 09 / 2013)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.Editorial changes were made to this summary.