Should Patients Being Considered for Surgical Management in Melanoma Centers Have Their Histology Reviewed by Specialized Pathologists?
- Alistair J. Cochran MD
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The outlook for patients with cutaneous melanoma has substantially improved. This is attributable to a variety of factors, including enhanced patient and professional awareness of the clinical events and changes in appearance that mark the early evolution of cutaneous melanoma. This facilitates early clinical diagnosis at a time when local surgery can be curative. Increasingly, logical approaches to the extent of surgical clearance of primary tumors and new approaches to the management of the regional lymph nodes have also been contributory.1,2 Primary care physicians and general dermatologists, while willing to undertake excision of nonmelanocytic and clinically benign melanocytic lesions, are less often willing to undertake definitive excision of diagnostically established primary melanomas, and are seldom prepared to perform lymphatic mapping and sentinel node biopsy. This has led to the evolution of highly specialized “melanoma surgeons” who work in complex multidisciplinary units ...
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- Morton DL, Thompson JF, Cochran AJ, et al for the MSLT Group. Final trial report of sentinel-node biopsy versus nodal observation in melanoma. N Engl J Med. 2014;370(7):599–609. CrossRef
- Niebling MG, Haydu LE, Karim RZ, Thompson JF, Scolyer RA. Pathology review significantly affects diagnosis and treatment of melanoma patients: an analysis of 5011 patients treated at a melanoma treatment center. Ann Surg Oncol. 2014. doi:10.1245/s10434-014-3682-x.
- Australian Cancer Network Melanoma Guidelines Revision Working Party. Clinical Practice Guidelines for the Management of Melanoma in Australia and New Zealand. Cancer Council Australian Cancer Network, Sydney and New Zealand Guidelines Group, Wellington, 2008.
- Wong SL, Balch CM, Hurley P, et al. Sentinel lymph node biopsy for melanoma: American Society of Clinical Oncology and Society of Surgical Oncology joint clinical practice guideline. Ann Surg Oncol. 2012;19(11):3313–24. CrossRef
- Ohsie SJ, Sarantopoulos GP, Cochran, AJ, et al. Immunohistochemical characteristics of melanoma. J Cutan Pathol. 2008; 35(5):433–44. CrossRef
- Santillan AA, Messina JL, Marzban SS, et al. Pathology review of thin melanoma and melanoma in situ in a multidisciplinary melanoma clinic: Impact on treatment decisions. J Clin Oncol. 2010;28(3):481–6. CrossRef
- Should Patients Being Considered for Surgical Management in Melanoma Centers Have Their Histology Reviewed by Specialized Pathologists?
Annals of Surgical Oncology
Volume 21, Issue 7 , pp 2124-2126
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- Springer US
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- Alistair J. Cochran MD (1) (2)
- Author Affiliations
- 1. Pathology, Laboratory Medicine and Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- 2. Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angels, CA, USA