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Bhartiya P, Jaiswal A, Negi M, Kaushik N, Ha Choi E, Kumar Kaushik N. Unlocking melanoma Suppression: Insights from Plasma-Induced potent miRNAs through PI3K-AKT-ZEB1 axis. J Adv Res 2024:S2090-1232(24)00084-5. [PMID: 38447612 DOI: 10.1016/j.jare.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/09/2024] [Accepted: 02/28/2024] [Indexed: 03/08/2024] Open
Abstract
INTRODUCTION Melanoma is a rare but highly malignant form of skin cancer. Although recent targeted and immune-based therapies have improved survival rates by 10-15%, effective melanoma treatment remains challenging. Therefore, novel, combinatorial therapy options such as non-thermal atmospheric pressure plasma (NTP) are being investigated to inhibit and prevent chemoresistance. Although several studies have reported the apoptotic and inhibitory effects of reactive oxygen species produced by NTP in the context of melanoma, the intricate molecular network that determines the role of microRNAs (miRNAs) in regulating NTP-mediated cell death remains unexplored. OBJECTIVES This study aimed to explore the molecular mechanisms and miRNA networks regulated by NTP-induced oxidative stress in melanoma cells. METHODS Melanoma cells were exposed to NTP and then subjected to high-throughput miRNA sequencing to identify NTP-regulated miRNAs. Various biological processes and underlying molecular mechanisms were assessed using Alamar Blue, propidium iodide (PI) uptake, cell migration, and clonogenic assays followed by qRT-PCR and flow cytometry. RESULTS NTP exposure for 3 min was sufficient to modulate the expression of several miRNAs, inhibiting cell growth. Persistent NTP exposure for 5 min increased differential miRNA regulation, PI uptake, and the expression of genes involved in cell cycle arrest and death. qPCR confirmed that miR-200b-3p and miR-215-5p upregulation contributed to decreased cell viability and migration. Mechanistically, inhibiting miR-200b-3p and miR-215-5p in SK-2 cells enhancedZEB1, PI3K, and AKT expression, increasing cell proliferation and viability. CONCLUSION This study demonstrated that NTP exposure for 5 min results in the differential regulation of miRNAs related to the PI3K-AKT-ZEB1 axis and cell cycle dysregulation to facilitate melanoma suppression.
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Affiliation(s)
- Pradeep Bhartiya
- Plasma Bioscience Research Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Republic of Korea; Department of Biotechnology, College of Engineering, The University of Suwon, Hwaseong 18323, Republic of Korea
| | - Apurva Jaiswal
- Plasma Bioscience Research Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Manorma Negi
- Plasma Bioscience Research Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Neha Kaushik
- Department of Biotechnology, College of Engineering, The University of Suwon, Hwaseong 18323, Republic of Korea.
| | - Eun Ha Choi
- Plasma Bioscience Research Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Republic of Korea.
| | - Nagendra Kumar Kaushik
- Plasma Bioscience Research Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Republic of Korea.
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Khan M, Thompson J, Kiiskila L, Oboh O, Truong T, Prentice A, Assifi MM, Chung M, Wright GP. Timing and necessity of staging imaging in clinical stage II cutaneous melanoma: Cost-effectiveness and clinical decision analysis. Am J Surg 2023; 225:93-98. [PMID: 36400601 DOI: 10.1016/j.amjsurg.2022.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/02/2022] [Accepted: 10/12/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Preoperative imaging in clinical stage II melanoma is not indicated per National Comprehensive Cancer Network (NCCN) guidelines but remains common in clinical practice. METHODS Patients presenting with cutaneous clinical stage II melanoma from 2007 to 2019 were retrospectively reviewed. A clinical decision analysis with cost data was designed to understand ideal practice patterns in managing stage II melanoma, with pre-versus selective post-operative imaging as the initial decision node. RESULTS There were 277 subjects included, and 143 underwent preoperative imaging (49.5%). This changed management (i.e. no surgery) in one patient (0.4%). Overall, 16 patients had additional findings on imaging (5.8%). Upfront surgery with selective postoperative imaging was a more cost-effective strategy than routine performance of preoperative imaging, with savings of $1677 per patient. CONCLUSION Preoperative imaging is a low yield, costly approach for patients with clinical stage II melanoma with minimal impact on the decision to proceed with surgical management.
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Affiliation(s)
- Mariam Khan
- Spectrum Health General Surgery Residency Program, 100 Michigan St. NE, Grand Rapids, MI, USA, 49503.
| | - Jessica Thompson
- Spectrum Health General Surgery Residency Program, 100 Michigan St. NE, Grand Rapids, MI, USA, 49503.
| | - Lindsey Kiiskila
- Department of Surgery, Michigan State University College of Human Medicine, 15 Michigan St. NE, Grand Rapids, MI, USA, 49503.
| | - Oselenonome Oboh
- Department of Surgery, Michigan State University College of Human Medicine, 15 Michigan St. NE, Grand Rapids, MI, USA, 49503.
| | - Thao Truong
- Department of Surgery, Michigan State University College of Human Medicine, 15 Michigan St. NE, Grand Rapids, MI, USA, 49503.
| | - Anthony Prentice
- Spectrum Health Department of Nursing, Surgical Services, 100 Michigan St. NE, Grand Rapids, MI, USA, 49503.
| | - M Mura Assifi
- Division of Surgical Oncology, Spectrum Health Medical Group, 145 Michigan St. NE Suite 5500, Grand Rapids, MI, USA, 49503.
| | - Mathew Chung
- Division of Surgical Oncology, Spectrum Health Medical Group, 145 Michigan St. NE Suite 5500, Grand Rapids, MI, USA, 49503.
| | - G Paul Wright
- Division of Surgical Oncology, Spectrum Health Medical Group, 145 Michigan St. NE Suite 5500, Grand Rapids, MI, USA, 49503.
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Liu C, Zhao Z, Lv H, Yu J, Zhang P. Microneedles-mediated drug delivery system for the diagnosis and treatment of melanoma. Colloids Surf B Biointerfaces 2022; 219:112818. [PMID: 36084509 DOI: 10.1016/j.colsurfb.2022.112818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/16/2022] [Accepted: 08/29/2022] [Indexed: 11/26/2022]
Abstract
As an emerging novel drug delivery system, microneedles (MNs) have a wide range of applications in the medical field. They can overcome the physiological barriers of the skin, penetrate the outermost skin of the human body, and form hundreds of reversible microchannels to enhance the penetration of drugs and deliver drugs to the diseased sites. So they have great applications in the diagnosis and treatment of melanoma. Melanoma is a kind of malignant tumor, the survival rate of patients with metastases is extremely low. The traditional methods of surgery and drug treatment for melanoma are often accompanied by large adverse reactions in the whole body, and the drug concentration is low. The use of MNs for transdermal administration can increase the drug concentration, reduce adverse reactions in the treatment process, and have good therapeutic effect on melanoma. This paper introduced various types of MNs and their preparation methods, summarized the diagnosis and various treatment options for melanoma with MNs, focused on the treatment of melanoma with dissolved MNs, and made prospect of MNs-mediated transdermal drug delivery in the treatment of melanoma.
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Affiliation(s)
- Cheng Liu
- Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China
| | - Zhining Zhao
- Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China
| | - Hongqian Lv
- Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China
| | - Jia Yu
- Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China.
| | - Peng Zhang
- Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang 110016, China.
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Saaiq M, Zalaudek I, Rao B, Lee Y, Rudnicka L, Czuwara J, Giuffrida R, Wollina U, Jafferany M, Lotti T, Grabbe S, Goldust M. A brief synopsis on scalp melanoma. Dermatol Ther 2020; 33:e13795. [PMID: 32520414 DOI: 10.1111/dth.13795] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 06/04/2020] [Indexed: 12/12/2022]
Abstract
Melanoma constitutes one of the most sinister and troublesome malignancies encountered by humanity. Generally, the diagnosis of advanced melanoma connotes a grave prognosis, prompting a sense of looming threat of death, however, the early-stage detected disease responds well to robust treatment resulting in reasonable survivorship. Scalp melanomas are even more troublesome, because they typically exhibit more aggressive biologic behavior and are often diagnosed at a late stage. This review tries to comprehensively highlight the various diagnostic, therapeutic, and outcome aspects of scalp melanomas. The literature research includes peer-reviewed articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) till May 2020 and reference lists of respective articles. Only articles published in English language were included.
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Affiliation(s)
- Muhammad Saaiq
- Department of Plastic Surgery and Orthopedics, National Institute of Rehabilitation Medicine (NIRM), Islamabad, Pakistan
| | - Iris Zalaudek
- Dermatology Clinic, University of Trieste, Maggiore Hospital, Trieste, Italy
| | - Babar Rao
- Department of Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey, USA.,Department of Dermatology, Weill Cornell Medical Center, New York, New York, USA
| | - Young Lee
- Department of Dermatology, Chungnam National University, Daejeon, South Korea
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Czuwara
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Roberta Giuffrida
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany
| | - Mohammad Jafferany
- College of Medicine, Central Michigan University, Saginaw, Michigan, USA
| | - Torello Lotti
- Department of Dermatology, University of Studies Guglielmo Marconi, Rome, Italy
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Mohamad Goldust
- Department of Dermatology, University of Rome G. Marconi, Rome, Italy.,Department of Dermatology, University Medical Center Mainz, Mainz, Germany.,Department of Dermatology, University Hospital Basel, Basel, Switzerland
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Gomez GVB, Rinck-Junior JA, Oliveira C, Silva DHL, Mamoni RL, Lourenço GJ, Moraes AM, Lima CSP. PDCD1 gene polymorphisms as regulators of T-lymphocyte activity in cutaneous melanoma risk and prognosis. Pigment Cell Melanoma Res 2018; 31:308-317. [PMID: 29090522 DOI: 10.1111/pcmr.12665] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 10/07/2017] [Indexed: 01/16/2023]
Abstract
This study aimed to evaluate whether PD1.1 (c.-606G>A), PD1 (c.627 + 252C>T), PD1.5 (c.804C>T), and PD1.9 (c.644C>T) single nucleotide polymorphisms of PDCD1 gene influence the risk, clinicopathological aspects, and survival of cutaneous melanoma (CM). Individuals with phototype I or II and PD1 CC genotype were under 5.89-fold increased risk of developing CM. PD1.5 TT genotype increased PDCD1 expression (2.49 versus 1.28 arbitrary units, p = .03) and PD1.5 CT or TT genotype and allele T increased PD1 expression in TCD4+ lymphocytes (16.6 versus 12.5%, p = .01; 17.0 versus 13.1%, p = .006). At 60 months of follow-up, short recurrence-free survival was seen in patients with PD1.1 AA genotype (33.3 versus 71.8%, p = .03). Patients with PD1.1 AA and PD1.5 CC genotype had 4.21 and 2.62 more chances of presenting relapse and evolving death by disease in Cox analyses, respectively. Our data provide preliminary evidence that abnormalities in regulation of T lymphocyte alter CM risk, clinical aspects, and prognosis.
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Affiliation(s)
- Gabriela V B Gomez
- Clinical Oncology Service, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - José A Rinck-Junior
- Clinical Oncology Service, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Cristiane Oliveira
- Clinical Oncology Service, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Dennis H L Silva
- Department of Clinical Pathology, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Ronei L Mamoni
- Department of Clinical Pathology, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Gustavo J Lourenço
- Laboratory of Cancer Genetics, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Aparecida M Moraes
- Clinical Oncology Service, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Carmen S P Lima
- Clinical Oncology Service, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
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DOEPKER MATTHEWP, THOMPSON ZACHARYJ, HARB JENNIFERN, MESSINA JANEL, PULEO CHRISTOPHERA, EGAN KATHLEENM, SARNAIK AMODA, GONZALEZ RICARDOJ, SONDAK VERNONK, ZAGER JONATHANS. Dermal melanoma: A report on prognosis, outcomes, and the utility of sentinel lymph node biopsy. J Surg Oncol 2016; 113:98-102. [PMID: 26661407 PMCID: PMC4904728 DOI: 10.1002/jso.24088] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 10/24/2015] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Historically dermal melanoma (DM) has been labeled as either stage IIIB (in-transit) or stage IV (M1a) disease. We sought to investigate the natural history of DM and the utility and prognostic significance of sentinel lymph node biopsy (SLNB). METHODS Patients with DM undergoing SLNB at a single center from 1998 to 2009 were identified. RESULTS Eighty-three patients met criteria, 10 (12%) patients had a positive SLNB. Of those, 5 (50%) recurred (all with distant disease). Twenty-one (29%) of the 73 SLNB negative patients recurred and of those, 15 (71%) developed distant metastases, whereas 6 (29%) developed local or regional recurrence, including two false-negative regional nodal recurrences. No in-transit recurrences were recorded. Five-year recurrence-free and disease-specific survival was significantly better for patients with a negative SLNB versus positive SLNB (56.8% vs. 22.2% P = 0.02, 81.1% vs. 61.0%, P = 0.05, respectively). CONCLUSION SLNB has prognostic significance for RFS and DSS, and should be utilized in the management of DM based on a >10% yield and low false-negative rate. Our data demonstrate patients with DM do not recur in an in-transit fashion, which along with the survival outcomes suggest the behavior of DM is consistent with primary cutaneous melanoma of similar thickness rather than an isolated in-transit or distant dermal metastasis from a regressed cutaneous primary.
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Affiliation(s)
| | | | - JENNIFER N. HARB
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - JANE L. MESSINA
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | | | - KATHLEEN M. EGAN
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - AMOD A. SARNAIK
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | | | - VERNON K. SONDAK
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - JONATHAN S. ZAGER
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
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Grossmann KF, Margolin K. Long-term survival as a treatment benchmark in melanoma: latest results and clinical implications. Ther Adv Med Oncol 2015; 7:181-91. [PMID: 26673806 DOI: 10.1177/1758834015572284] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Historically, stage III-IV melanoma patients have had few options to achieve long-term survival. For patients with stage III disease, surgery alone may be curative for approximately 50%. Adjuvant treatment with a slightly greater impact on relapse-free survival at the cost of substantial toxicity, and studies are ongoing to test the adjuvant benefit of other immunotherapies that appear more active and less toxic in advanced melanoma. Achieving long term survival for stage IV patients had been rare until recently and progress was painfully slow with traditional cytotoxic chemotherapy; review of multiple phase II studies showed universally poor results. Fortunately, since the approval by the US Food and Drug Administration of agents targeting the cytotoxic T lymphocyte antigen-4 (CTLA-4) receptor, as well as those targeting B-raf and mitogen-activated protein kinase kinase (MEK) in the mitogen-activated protein kinase (MAPK) pathway for patients whose melanoma is 'driven' by a BRAF mutation, long-term survival of stage IV melanoma is increasing substantially. Here we review the examples of studies documenting potentially curative approaches to melanoma and propose suggestions for the use of various treatments in achieving this important goal.
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Affiliation(s)
- Kenneth F Grossmann
- Division of Oncology, Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Kim Margolin
- Division of Oncology, Stanford University, Stanford, CA, USA
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Gomez GVB, de Oliveira C, Rinck-Junior JA, de Moraes AM, Lourenço GJ, Lima CSP. XPC (A2920C), XPF (T30028C), TP53 (Arg72Pro), and GSTP1 (Ile105Val) polymorphisms in prognosis of cutaneous melanoma. Tumour Biol 2015; 37:3163-71. [PMID: 26427666 DOI: 10.1007/s13277-015-4123-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 09/20/2015] [Indexed: 11/30/2022] Open
Abstract
This study aimed to evaluate whether XPC A2920C, XPF T30028C, TP53 Arg72Pro, and GSTP1 Ile105Val polymorphisms alter outcomes of cutaneous melanoma (CM) patients. DNA from 237 CM patients seen at the University of Campinas Teaching Hospital from April 2000 to February 2014 was analyzed by polymerase chain reaction and restriction fragment length polymorphism assays. The prognostic impact of genotypes of polymorphisms on progression-free survival (PFS) and overall survival (OS) of CM patients were examined using the Kaplan-Meier probability estimates and univariate and multivariate Cox regression analyses. At 60 months of follow-up, shorter PFS and OS were seen in patients with XPF CC genotype (48.9 vs. 66.7 %, P = 0.002; 77.9 vs. 83.5 %, P = 0.006, respectively) and XPF CC + TP53 ArgArg (43.6 vs. 65.9 %, P = 0.007; 71.6 vs. 84.8 %, P = 0.006, respectively) compared with those with remaining genotypes (Kaplan-Meier estimates). Patients with XPF CC (hazard ratio (HR) 2.45, P = 0.002; HR 3.77, P = 0.005) and XPF CC + TP53 ArgArg (HR 2.67, P = 0.009; HR 4.04, P = 0.03) genotypes had more chance to present tumor progression in univariate and multivariate analyses, whereas patients with XPF CC (HR 2.78, P = 0.009) and XPF CC + TP53 ArgArg (HR 3.84, P = 0.01) genotypes were under greater risk of progressing to death in univariate analysis, compared with those with the remaining genotypes. The data suggest, for the first time, that inherited abnormalities in DNA repair pathway related to XPF 30028C and TP53 Arg72Pro polymorphisms act as prognostic factors for PFS and OS of CM patients.
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Affiliation(s)
- Gabriela Vilas Bôas Gomez
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Rua Alexander Fleming, 181, Barão Geraldo, São Paulo, 13083-970, Campinas, Brazil
| | - Cristiane de Oliveira
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Rua Alexander Fleming, 181, Barão Geraldo, São Paulo, 13083-970, Campinas, Brazil
| | - José Augusto Rinck-Junior
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Rua Alexander Fleming, 181, Barão Geraldo, São Paulo, 13083-970, Campinas, Brazil
| | - Aparecida Machado de Moraes
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Rua Alexander Fleming, 181, Barão Geraldo, São Paulo, 13083-970, Campinas, Brazil
| | - Gustavo Jacob Lourenço
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Rua Alexander Fleming, 181, Barão Geraldo, São Paulo, 13083-970, Campinas, Brazil
| | - Carmen Silvia Passos Lima
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Rua Alexander Fleming, 181, Barão Geraldo, São Paulo, 13083-970, Campinas, Brazil.
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Zuluaga-Sepúlveda MA, Arellano-Mendoza I, Ocampo-Candiani J. [Update on surgical treatment of primary and metastatic cutaneous melanoma]. CIR CIR 2015; 84:77-84. [PMID: 26277601 DOI: 10.1016/j.circir.2015.06.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 12/10/2014] [Indexed: 11/27/2022]
Abstract
Melanoma is a common cutaneous tumour. It is of great importance due to its increasing incidence and aggressive behaviour, with metastasis to lymph nodes and internal organs. When suspecting melanoma, excisional biopsy should be performed to obtain complete histological information in order to determine the adverse factors such as ulceration, mitosis rate, and Breslow depth, which influence preoperative staging and provide data for sentinel lymph biopsy decision making. The indicated management for melanoma is wide local excision, observing recommended and well-established excision margins, depending on Breslow depth and anatomical location of the tumour. Therapeutic lymphadenectomy is recommended for patients with clinically or radiologically positive lymph nodes. This article reviews surgical treatment of melanoma, adverse histological factors, sentinel lymph node biopsy, and radical lymphadenectomy. Details are presented on special situations in which management of melanoma is different due to the anatomical location (plantar, subungual, lentigo maligna), or pregnancy.
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Affiliation(s)
| | - Ivonne Arellano-Mendoza
- Servicio de Dermatología, Hospital General de México Dr. Eduardo Liceaga, México D.F., México
| | - Jorge Ocampo-Candiani
- Servicio de Dermatología, Hospital Universitario Dr. José E. González, Monterrey, Nuevo LeónMéxico.
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