Harriet S.MeyerMD, Contributing EditorJonathan D.EldredgeMLS, PhD, Journal Review EditorRobertHoganMD, adviser for new media
Malignant melanoma is the most serious cutaneous cancer, and its incidence is increasing faster than any serious tumor here and abroad. Despite major advances in tumor biology, the treatment of advanced melanoma has remained a major challenge. While, for all practical purposes, adequate excision provides cure for early lesions, once the disease crosses local boundaries there are no truly effective modalities to control its progression.
The prognosis of early malignant melanoma is based on the thickness and depth of the primary lesion. Involvement of adjacent tissues and the presence or absence of lymph node and distant metastases are used in staging. The tumor cell load and the host immune response have relevance to the control and prognosis of melanoma. While certain types of primary lesions initially progress more slowly, once the tumor reaches a more advanced stage, the prognosis becomes poor for all types—lentigo maligna (in situ) and superficial spreading, nodular, and acrolentiginous malignant melanoma. Hereditary tendency, repeated ultraviolet exposure, especially sunburn in childhood, and the general state of immunity are currently considered important in the pathogenesis and progression of malignant melanoma. Very large congenital nevi are associated with a higher incidence.
MelanomaCutaneous Melanoma. JAMA. 1998;280(1):99-100. doi:10.1001/jama.280.1.99-JBK0701-3-1