Table of Contents
ISRN Dermatology
Volume 2013 (2013), Article ID 616170, 10 pages
http://dx.doi.org/10.1155/2013/616170
Review Article

Melanoma M (Zero): Diagnosis and Therapy

1Melanoma and Sarcoma Unit, Veneto Institute of Oncology, IOV IRCCS, 35128 Padua, Italy
2Dermatology Unit, University of Padua, 35128 Padua, Italy
3Department of Medical Diagnostic Sciences and Special Therapies, University of Padua, 35128 Padua, Italy
4Medical Oncology Unit, Veneto Institute of Oncology, IOV IRCCS, 35128 Padua, Italy
5Institute of Anatomopathology, University of Padua, 35128 Padua, Italy
6Department of Surgical Oncological and Gastroenterological Sciences, Padua University, 35128 Padua, Italy

Received 13 February 2013; Accepted 19 March 2013

Academic Editors: M. Clelia, J. del Pozo Losada, and A. R. Ercocen

Copyright © 2013 Marco Rastrelli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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 ≥1. 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.