%0 Journal Article
%T Adjuvant Treatment of Melanoma
%A J. A. Moreno Nogueira
%A M. Valero Arbizu
%A R. P¨¦rez Temprano
%J ISRN Dermatology
%D 2013
%R 10.1155/2013/545631
%X Melanomas represent 4% of all malignant tumors of the skin, yet account for 80% of deaths from skin cancer.While in the early stages patients can be successfully treated with surgical resection, metastatic melanoma prognosis is dismal. Several oncogenes have been identified in melanoma as BRAF, NRAS, c-Kit, and GNA11 GNAQ, each capable of activating MAPK pathway that increases cell proliferation and promotes angiogenesis, although NRAS and c-Kit also activate PI3 kinase pathway, including being more commonly BRAF activated oncogene. The treatment of choice for localised primary cutaneous melanoma is surgery plus lymphadenectomy if regional lymph nodes are involved. The justification for treatment in addition to surgery is based on the poor prognosis for high risk melanomas with a relapse index of 50¨C80%. Patients included in the high risk group should be assessed for adjuvant treatment with high doses of Interferon-¦Á2b, as it is the only treatment shown to significantly improve disease free and possibly global survival. In the future we will have to analyze all these therapeutic possibilities on specific targets, probably associated with chemotherapy and/or interferon in the adjuvant treatment, if we want to change the natural history of melanomas. 1. Introduction Melanomas constitute 2-3% of all cancers, 95% presented as skin cancer and only 5% in nonskin locations. It represents 4% of all malignant tumors of the skin, yet account for 80% of deaths from skin cancer. The incidence in Spain adjusted per 100,000 populations is 5.85 for men and 7.50 for women, according to published data. In the U.S. 76,250 new cases are expected for 2012 (44,250 men and 32,000 women) and a mortality rate of 9180 patients. Using data from 2005¨C2009 the age-adjusted incidence was 21.0 per 100,000 (27.2 for men and 16.7 for women). The highest incidence occurs in Australia and New Zealand (38/100.000 inhabitants) and Japan has just 0.47 per 100,000 population, which is indicative of the different incidence rates by geographic areas. Globocan¡¯s data from 2008 shows an incidence of 199.627 cases and a mortality of 46.372 (M: 101.807/25.860 and W: 97.820/20512), when in 2002 the incident was 160.000 (M£¿:£¿F sex ratio, 0.97) and the mortality 41.000 (M£¿:£¿F sex ratio, 1.2) [1]. Melanoma is one of the neoplasms that is increasing the most, both young and old, exceeded only by the liver and thyroid cancer. It is currently the fifth most common cancer in men and the seventh in women. While in the early stages patients can be successfully treated with surgical resection, metastatic
%U http://www.hindawi.com/journals/isrn.dermatology/2013/545631/