%0 Journal Article
%T Melanoma M (Zero): Diagnosis and Therapy
%A Marco Rastrelli
%A Mauro Alaibac
%A Roberto Stramare
%A Vanna Chiarion Sileni
%A Maria Cristina Montesco
%A Antonella Vecchiato
%A Luca Giovanni Campana
%A Carlo Riccardo Rossi
%J ISRN Dermatology
%D 2013
%R 10.1155/2013/616170
%X This paper reviews the epidemiology, diagnosis, and treatment of M zero cutaneous melanoma including the most recent developments. This review also examined the main risk factors for melanoma. Tumor thickness measured according to Breslow, mitotic rate, ulceration, and growth phase has the greatest predictive value for survival and metastasis. Wide excision of the primary tumor is the only potentially curative treatment for primary melanoma. The sentinel node biopsy must be performed on all patients who have a primary melanoma with a Breslow thickness > 1£¿mm, or if the melanoma is from 0,75£¿mm to 1£¿mm thick but it is ulcerated and/or the mitotic index is ¡Ý1. Total lymph node dissection consists in removing the residual lymph nodes in patients with positive sentinel node biopsy, or found positive on needle aspiration biopsy, without radiological evidence of spread. Isolated limb perfusion and isolated limb infusion are employed in patients within transit metastases with a rate of complete remission in around 50% and 38% of cases. Electrochemotherapy is mainly indicated for palliation in cases of metastatic disease, though it may sometimes be useful to complete isolated limb perfusion. The only agent found to affect survival as an adjuvant treatment is interferon alpha-2. Adjuvant radiotherapy improves local control of melanoma in patients at a high risk of recurrence after lymph node dissection. 1. Introduction Since the 1960s, malignant melanoma incidence has increased in Caucasian populations, and consequently this neoplasm has become one of the most frequent cancer in fair-skinned populations. Melanoma is now regarded as the fifth most common cancer in men and the sixth most common cancer in woman in the United States. The highest recorded incidence of melanoma worldwide is in Queensland (Australia) with an incidence equal to 55.8/105/annum for males and 41.1/105/annum for females. Reported incidence rates vary for Europe and are the highest in Switzerland and Scandinavian countries. In Europe, there is a north-south gradient in incidence rates with the highest rates in northern countries and the lowest ones in the southern countries. This is probably due to both the increased protection against UV exposure of the highly pigmented skin of southern Europeans and the different pattern of sun exposure (chronic in southern Europeans, intermittent in northern Europeans). In parallel with the increased incidence rate, there is an increase of melanoma related-mortality. The median age at the time of diagnosis is 57 years, and the incidence increases after
%U http://www.hindawi.com/journals/isrn.dermatology/2013/616170/