Controversies in melanoma -Professor Torello Lotti, MD - University G.Marconi, Rome, Italy - and Linda Tognetti, MD - Department of Dermatologic Sciences University of Florence, Italy
•Télécharger en tant que PPT, PDF•
1 j'aime•1,029 vues
etiopathogenesis: The role of sun exposure Hormons and melanoma The role of Sentinel Lymph Node Biopsy The role of Contrast Enanched Ultra Sound The role of Electron Paramagnetic Resonance Excisional VS incisional biopsy
Recommandé
Contenu connexe
Tendances
Tendances (20)
En vedette
En vedette (20)
Similaire à Controversies in melanoma -Professor Torello Lotti, MD - University G.Marconi, Rome, Italy - and Linda Tognetti, MD - Department of Dermatologic Sciences University of Florence, Italy
Similaire à Controversies in melanoma -Professor Torello Lotti, MD - University G.Marconi, Rome, Italy - and Linda Tognetti, MD - Department of Dermatologic Sciences University of Florence, Italy (20)
Dernier
Dernier (20)
Controversies in melanoma -Professor Torello Lotti, MD - University G.Marconi, Rome, Italy - and Linda Tognetti, MD - Department of Dermatologic Sciences University of Florence, Italy
- 1. Controversies in melanoma Torello Lotti Department of Dermatologic Sciences University of Florence, Italy The International School of Vitiligo & Pigmentary Disorders Barcelona, 2-5 November 2011
- 2. Controversies in melanoma’s… - epidemiology : Melanoma epidemic: true or false? - etiopathogenesis : The role of sun exposure Hormons and melanoma - diagnosis & treatment : The role of S entinel Lymph Node Biopsy The role of Contrast Enanched Ultra Sound The role of Electron Paramagnetic Resonance Excisional VS incisional biopsy
- 5. They believe that this worldwide melanoma incidence increase represents a true epidemic take the statistics at face value, with the concept “ res ipsa loquitur”. FAVOURABLE Rigel DS, Friedman RJ, Kopf AW, et al. Melanoma incidence: if it quacks like a duck. Arch Dermatol 1997;133:656–658 Beddingfield FC, The melanoma epidemic: res ipsa loquitur. Oncologist 2003;8 :459–465 Melanoma epidemic…?
- 7. Melanoma epidemic…? In general, the question posed of whether a melanoma epidemic truly exists has not yet a definitive answer, because of the absence of randomized controlled trials which can evaluate the true effect of increased surveillance and biopsies on mortality rates. Erickson C, Driscoll MS. Melanoma epidemic: Facts and controversies. Clinic Dermatol 2010;28(3):281-286.
- 12. Gradual and continuous exposure can play a protective role for the photoexposed persons. Ricceri F. De Giorgi V. Lotti . Melanoma:un’ipotesi eretica relativamente alla fotoesposizione cronica. In: De Giorgi V, Aricò M, Lotti T, eds. Il melanoma. Prevenzione, diagnosi e terapia. Tortona: Fernando Folini; 2008. pp:15-20. intermittent exposure Intermittent, acute and intense exposure increases the possibility to develop melanoma and basal cell carcinoma (BCC). Chronic intense UV exposure is more typically associated with the squamous cell carcinoma (SCC) and actinic keratosis. Among children, melanoma risk is most associated with intermittent sunburns. De Giorgi V, Gori A, Grazzini M et al. Sun exposure and children: what do they know? An observational study in an Italian school. Prev Med 2011; 52: 186-187. continuous exposure vs It is though to be harmless for the melanoma. It is defined as “recreational” or “vacation exposure”: melanoma often appears in sites not usually covered by the seasonal habits and therefore attainable by UVR Moan J, Porojnicu AC, Dahlback A et al. Where the sun does not shine: Is sunshine protective against melanoma of the vulva? J Photochem Photobiol B 2010; 101: 179-183
- 18. - Diagnosis & treatment -
- 25. The postulate that all the positive sentinel nodes inevitably progress to nodal disease is not correct, because it can happen that some micrometastases in the sentinel node can disappear for host immune processes or can remain in a dormancy state. De Giorgi V, Grazzini M, Papi F et al. Sentinel lymph node biopsy: Is it an evolution of the management of cutaneous melanoma?Ann Surg Oncol 2011;18:597 De Giorgi V, Grazzini M, Massi D. Sentinel-lymph-node biopsy for cutaneous melanoma. N Engl J Med 2011; 365: 570-571 Thomas JM . Caution with sentinel node biopsy in melanoma.Br J Surg 2006; 93: 129-130 1 2 It has never been shown that the lymphadenectomy performed after a positive SN finding really improves the survival of melanoma patients. Thomas JM. Time to re-evaluate sentinel node biopsy in melanoma postmulticenter selective lymphadenectomy trial. J Clin Oncol 2005; 23: 9443-4 The role of sentinel lymph node biopsy
- 26. The postulate that all the positive SN inevitably progress to nodal disease is not correct, because it can happen that some micrometastases in the sentinel node can disappear for host immune processes or can remain in a dormancy state. 1 2 3 It has never been shown that the lymphadenectomy performed after a positive SN finding really improves the survival of melanoma patients. Results from Multicentre Selective Lymphadenectomy Trials (MSLT-I and II) have showed that SLNB do not significantly improve overall survival , by comparing the observation group and the biopsy group, but it helps reducing time for lymph node metastases detection earlier identification of the natural disease progression Amersi F, Morton DL . The role of sentinel lymph node biopsy in the management of melanoma. Adv Surg 2007; 41: 241-256 De Giorgi V, Leporatti G, Massi D et al. Sentinel lymph nodes in melanoma patients: evaluating the evidence. Oncology 2006; 71: 460-2 De Giorgi V, Leporatti G, Massi D et al. Outcome of patients with melanoma and histologically negative sentinel lymph nodes: one institution’s experience.Oncology 2007; 73: 401-6 The role of sentinel lymph node biopsy