Cutaneous melanoma: a twenty-year retrospective study with clinicopathologic correlation

Area of Science:

• Oncology
• Surgical Oncology
• Medical Oncology

Background:

• Melanoma patient survival is linked to regional lymph node status and tumor invasion depth.
• Aggressive surgical approaches over the last decade have significantly improved 5-year survival rates.
• Regional lymph node involvement historically portended a poorer prognosis.

Purpose of the Study:

• To evaluate the impact of aggressive surgical therapies on melanoma patient survival.
• To assess the efficacy of L-phenylalanine mustard perfusion in patients with lymph node involvement.
• To determine if melanoma aggressiveness can be predicted for optimized treatment strategies.

Main Methods:

• Review of patient outcomes over the past 10 years.
• Analysis of survival rates following wide local excision and prophylactic lymph node dissection.
• Evaluation of 5-day L-phenylalanine mustard infusion for regional lymph node-positive melanoma patients.

Main Results:

• Five-year survival rates for melanoma patients have more than doubled.
• Patients with regional lymph node involvement showed doubled 5-year survival with L-phenylalanine mustard infusion.
• Perfusion of lower extremities with L-phenylalanine mustard is no longer practiced at Vanderbilt.

Conclusions:

• Aggressive surgical management has dramatically improved melanoma survival.
• L-phenylalanine mustard perfusion offers a survival benefit for lymph node-positive melanoma.
• Predictive assessment of melanoma aggressiveness is crucial for effective treatment planning.