Clinicopathological Features, Staging, and Current Approaches to Treatment in High-Risk Resectable Melanoma
Open Access
- 15 February 2020
- journal article
- research article
- Published by Oxford University Press (OUP) in JNCI Journal of the National Cancer Institute
- Vol. 112 (9), 875-885
- https://doi.org/10.1093/jnci/djaa012
Abstract
The incidence of melanoma in the United States has been increasing over the past several decades. Prognosis largely depends on disease stage, with 5-year melanoma-specific survival ranging from as high as 99% in patients with stage I disease to less than 10% for some patients with stage IV (distant metastatic) disease. Fortunately, in the last 5–10 years, there have been remarkable treatment advances for patients with high-risk resectable melanoma, including approval of targeted and immune checkpoint blockade therapies. In addition, results of recent clinical trials have confirmed the importance of sentinel lymph node biopsy and continue to refine the approach to regional lymph node basin management. Lastly, the melanoma staging system was revised in the eighth edition AJCC Cancer Staging Manual, which was implemented on January 1, 2018. Here we discuss these changes and the clinicopathological features that confer high risk for locoregional and distant disease relapse and poor survival. Implications regarding the management of melanoma in the metastatic and adjuvant settings are discussed, as are future directions for neoadjuvant therapies.Funding Information
- University of Texas MD Anderson Cancer Center Melanoma Moon Shots Program
- Robert and Lynne Grossman Family Foundation
- Michael and Patricia Booker Melanoma Research Endowment
- National Institutes of Health (T32 CA009599)
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