Future perspectives on malignant melanoma

Emphasis for the treatment of melanoma should be shifted more to prevention and early diagnosis, because early melanoma may potentially be cured in most cases. Clinical trials are important to establish more effective adjuvant modalities against melanoma. Multifaceted aspects of micrometastasis, including differentiation of different clones with respect to the primary tumor, acquisition of adhesion molecules, and host interaction with the microscopic tumor, will shed new light on the biology and mechanism of early metastasis. New molecular and genetic tools may be used to dissect the mechanisms of lymphatic and hematogenous routes of metastasis. If such mechanisms can be understood, potential therapeutic maneuvers can be developed to prevent the process of micrometastasis.