NEW ASPECTS OF MANAGEMENT OF MALIGNANT-MELANOMA

The incidence of melanoma continues to increase throughout the world. Caucasians with particular phenotypic features seem to be affected most. Epidemiologic studies suggest that intermittent sun exposure, especially in early age, increases the risk of melanoma. If melanoma is diagnosed early and treated with adequate surgery, prognosis is excellent. Once melanoma has metastasized to the regional lymph nodes, the majority of patients have a recurrence within 5 years. Adjuvant modalities, currently being tested in many phase III studies, are designed to improve survival of these patients. Isolated limb perfusion with tumor necrosis factor induces complete responses in the majority of patients with in-transit disease. Median survival of patients with distant metastasis is only 6-8 months, and thus far systemic therapy has not significantly prolonged survival, despite remission rates of 30-50%.