de Braud Filippo, Khayat David, Kroon Bin B R, Valdagni Riccardo, Bruzzi Paolo, Cascinelli Natale
START Project, European Institute of Oncology, Milan, Italy.
Crit Rev Oncol Hematol. 2003 Jul;47(1):35-63. doi: 10.1016/s1040-8428(02)00077-x.
In the European Community cutaneous melanoma accounts for 1 and 1.8% of cancers occurring in men and women, respectively. The incidence rate is increasing faster than that of any other tumour. Sun exposure, patient's phenotype, family history, and history of a previous melanoma are the major risk factors. The change over a period of months is the main sign of a skin lesion turned into a melanoma. The ABCDE scheme for early detection of melanoma is commonly accepted. A new staging classification will be published in the next AJCC/UICC Cancer Staging System Manual in 2002. The clinical course of melanoma is determined by its dissemination and depends on thickness, ulceration, localisation, gender and histology of the primary tumour. Tumour stage at diagnosis remains the major prognostic factor. Surgery is the standard treatment option for operable local-regional disease. Sentinel node biopsy represents a promising experimental approach in the clinical detection and early treatment of occult lymph node involvement. For metastatic inoperable patients systemic chemotherapy can be attempted, while radiation therapy has to be considered as palliative treatment. No studies concerning frequency of follow-up are currently available, but common procedures may be performed.
在欧洲共同体，皮肤黑素瘤分别占男性和女性所患癌症的1%和1.8%。其发病率的增长速度比其他任何肿瘤都要快。阳光照射、患者的表型、家族病史以及既往黑素瘤病史是主要的危险因素。数月内的变化是皮肤病变转变为黑素瘤的主要迹象。用于黑素瘤早期检测的ABCDE方案已被广泛接受。一种新的分期分类将在2002年出版的下一版美国癌症联合委员会/国际抗癌联盟癌症分期系统手册中公布。黑素瘤的临床病程由其扩散情况决定，并取决于原发肿瘤的厚度、溃疡情况、部位、性别和组织学类型。诊断时的肿瘤分期仍然是主要的预后因素。手术是可手术的局部区域疾病的标准治疗选择。前哨淋巴结活检是隐匿性淋巴结受累临床检测和早期治疗中一种有前景的实验方法。对于无法手术的转移性患者，可以尝试全身化疗，而放射治疗必须被视为姑息治疗。目前尚无关于随访频率的研究，但可以进行一些常规检查。
