Adjuvant Treatment of Melanoma. Review of Contemporary Therapeutic Approaches

Overview

The basic therapeutic method used in primary melanoma is surgery. Depending on the stage of the disease, however, the subsequent course of the disease changes markedly. To gain an accurate idea on the prognosis of the disease it is always necessary to knoty the Breslow value - the thickness of the tumour in mm. Recently, however, among important prognostic factors the state of the sentinel node is included. Metastases in the sentinel node cause deterioration of the course of the disease and the risk of a relapse increases markedly. At present there is not yet known any effective treatment of metastases of melanoma. Despite the relatively high percentage of therapeutic responses, in particular after combined chemoimmunotherapy, it does not prove possible to prolong the patients' survival.In the foreground of interest is increasingly adjuvant treatment of melanoma which assumes a minimal tumorous mass and a generally satisfactory status of the patient. According to most retem results of studies presented at the 5th World Congress on melanoma in Venice in March 2001 the basic adjuvant method in high risk melanoma stage IIb and III is administration of large doses of interferon a by the i.v. route according to the therapeutic pattern of the ECOG 1684 study. Melanoma vaccines, despite initial hopes, so far do not produce the expected results.

Key words:
melanoma - adjuvant treatment - sentinel node - IFN a - melanoma vaccines