Thompson John F, Williams Gabrielle J
Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Oncotarget. 2024 Jun 13;15:374-378. doi: 10.18632/oncotarget.28591.
Selecting which patients with clinically-localized melanoma require treatment other than wide excision of the primary tumor is based on the risk or presence of metastatic disease. This in turn is linked to survival. Knowing if and when a melanoma is likely to metastasize is therefore of great importance. Several studies employing a range of different methodologies have suggested that many melanomas metastasize long before the primary lesion is diagnosed. Therefore, waiting for dissemination of metastatic disease to become evident before making systemic therapy available to these patients may be less effective than giving them post-operative adjuvant therapy initially if the metastatic risk is high. The identification of these high-risk patients will assist in selecting those to whom adjuvant systemic therapy can most appropriately be offered. Further studies are required to better identify high-risk patients whose primary melanoma is likely to have already metastasized.
选择哪些临床局限性黑色素瘤患者除了对原发肿瘤进行广泛切除之外还需要其他治疗，是基于转移疾病的风险或存在情况。这反过来又与生存率相关。因此，了解黑色素瘤是否以及何时可能发生转移非常重要。几项采用一系列不同方法的研究表明，许多黑色素瘤在原发病变被诊断出来之前很久就已经发生转移。因此，如果转移风险很高，在等待转移性疾病扩散变得明显后才对这些患者进行全身治疗，可能不如最初就给予他们术后辅助治疗有效。识别这些高危患者将有助于选择那些最适合接受辅助全身治疗的患者。需要进一步的研究来更好地识别那些原发性黑色素瘤可能已经发生转移的高危患者。
