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9781576261590

Cutaneous Melanoma

by
  • ISBN13:

    9781576261590

  • ISBN10:

    157626159X

  • Edition: 4th
  • Format: Hardcover
  • Copyright: 2003-01-01
  • Publisher: TAYLOR & FRANCIS
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List Price: $225.00

Summary

Johns Hopkins Medical Institutes, Baltimore, MD. Authoritative and comprehensive treatise with an emphasis on data presentation. Incorporates more than 30,000 patients treated at major melanoma centers throughout the world. Clinical management is supported by statistical data about natural history, prognosis, and treatment results. Previous edition: c1998. DNLM: Melanoma.

Table of Contents

Introduction A History of Melanoma: From Hunter to Clark 1(1)
G. Roderick McLeod
Neville C. Davis
Arthur J. Sober
John Hunter (1728--1793)
2(1)
Rene Laennec (1781--1826)
2(1)
William Norris (1792--1877)
3(2)
Other early nineteenth century descriptions
5(1)
Contemporary histories of melanoma
6(1)
James Paget (1814--1899)
6(1)
Oliver Pemberton (1825--1897)
6(1)
Sir Jonathan Hutchinson (1828--1913)
6(1)
Other late nineteenth century descriptions
7(1)
Early twentieth century articles
7(1)
William Sampson Handley (1872--1962)
7(1)
Sophie Spitz (1910--1956)
8(1)
Arthur Allen (1910--1994)
8(1)
Vincent J. McGovern (1915--1983)
9(1)
Alexander Breslow (1928--1980)
10(1)
Wallace H. Clark, Jr. (1924--1997)
10(1)
Conclusion
11(4)
Part I Epidemiology, Prognosis, and Staging
Epidemiology: Current Trends
15(10)
Marianne Berwick
Martin A. Weinstock
Incidence of Melanoma
16(3)
Racial differences
16(1)
Age adjustment of rates
16(1)
World incidence rates
17(1)
Incidence trends
17(1)
Cohort effects
17(1)
Anatomic site
18(1)
Age and sex
18(1)
Thickness
18(1)
Mortality
19(2)
Conclusions
21(4)
Prognostic Factors and Natural History
25(30)
Jeffrey E. Gershenwald
Charles M. Balch
Seng-jaw Soong
John F. Thompson
Validation of the American Joint Committee on Cancer Melanoma Staging System: Analysis of Prognostic Factors in 17,600 Patients With Melanoma
26(2)
Background
26(1)
Overview of the AJCC melanoma database
27(1)
Prognostic Factors in Primary Melanoma (Stages I and II)
28(12)
Critical analysis of the 1997 AJCC melanoma staging system
28(1)
AJCC melanoma database Cox multivariate analysis: Primary melanoma prognostic features
29(2)
Analysis of the AJCC database: Interaction of tumor thickness, ulceration, and level of invasion
31(4)
Other variables
35(4)
Conclusion: Stage I and II melanoma
39(1)
Prognostic Factors in Regionally Metastatic Melanoma (Stage III): Lymph Node Metastasis, Satellite Lesions, and In Transit Metastases
40(6)
Overview
40(1)
Prognostic significance of metastases to more than one lymph node basin
40(1)
Satellites vs. in transit metastases
40(2)
Microsatellites vs. macrosatellites
42(1)
Satellites vs. local recurrence
42(1)
Lymph node metastases
43(1)
AJCC melanoma database: Multivariate analysis of stage III patients
43(1)
Number of metastatic nodes
43(2)
Metastatic tumor burden
45(1)
Impact of primary tumor ulceration on stage III outcome
45(1)
Other variables
46(1)
Pathologic variables
46(1)
Prognostic Variables in Patients With Distant Metastatic Melanoma (Stage IV)
46(3)
Clinical variables
47(1)
Laboratory parameters
48(1)
Summary and Conclusion
49(6)
Staging and Classification
55(22)
Charles M. Balch
Jeffrey E. Gershenwall
Antonio C. Buzaid
Natale Cascinelli
Seng-jaw Soong
Historical Perspective
56(6)
Early attempts
56(1)
Evolution of microstaging
56(1)
M.D. Anderson staging system
57(1)
AJCC staging system
57(1)
Revised (2002) AJCC melanoma staging system
58(2)
Future developments in melanoma classification and staging systems
60(2)
Rules for Classification
62(1)
Clinical staging
62(1)
Pathologic staging
62(1)
Clinical vs. pathologic staging
62(1)
TNM Staging Criteria and Stage Groupings for Localized Melanoma (Stages I and II)
63(3)
TNM criteria
63(1)
Defining T1 melanomas
64(1)
Melanoma in situ, indeterminate melanomas, and multiple primary melanomas
65(1)
Melanoma growth patterns
65(1)
Data recording criteria for stage I and stage II melanomas
66(1)
TNM Staging Criteria and Stage Grouping for Regional Metastatic Melanoma (Stage III)
66(5)
TNM criteria
67(2)
Stage grouping for pathologic stage III melanoma
69(1)
Contiguous multiple nodal basins and staging
70(1)
Data recording criteria for stage III melanoma
70(1)
Prognosis and Staging of Distant Metastases (Stage IV)
71(1)
TNM criteria
71(1)
Data recording criteria for stage IV melanoma
72(1)
Recommendations for Clinical Trials
72(5)
Models for Predicting Outcome
77(16)
Seng-jaw Soong
Yuting Zhang
Renee A. Desmond
Description of the Mathematical Model
78(1)
Hazard function
78(1)
Survival function
79(1)
Predicting Outcome From Initial Diagnosis for Patients With Localized Melanoma
79(1)
Predicting Outcome From Initial Diagnosis in Patients With Regional Melanoma
79(3)
Predicting Outcome After a Disease-Free Interval in Patients With Localized Melanoma
82(5)
Clinical Applications
87(6)
Clinical scoring system
87(1)
Disease management decisions
87(1)
Patient risk classification
88(1)
Planning clinical trials
88(1)
Analysis of clinical studies
89(1)
Other applications
90(3)
Part II Screening: Clinical Assessment and Pathology
Prevention and Screening
93(28)
Mark Elwood
Joanne F. Aitken
Dallas R. English
Descriptive Epidemiology
94(2)
Current trends in incidence and mortality
94(1)
Trends by anatomic site and depth
94(1)
Interpretation of trends: Influence of early diagnosis and changes in medical care
95(1)
Geographic and ethnic variation in melanoma
96(1)
Risk Factors for Melanoma
96(10)
Family history
96(1)
Skin, hair, eye color, and ``skin type''
97(1)
Freckles
97(1)
Nevi
97(3)
Subsequent melanoma and other cancers
100(1)
Xeroderma pigmentosum
100(1)
Sun and ultraviolet exposure
100(5)
Other risk factors for melanoma
105(1)
Primary Prevention of Melanoma
106(2)
Screening to Detect Early Melanoma
108(6)
Self-screening and physician screening: The evidence
108(1)
The rationale for screening
108(1)
Outcomes and effectiveness of early-detection campaigns
109(1)
Education campaigns to promote early detection
109(1)
Open-access skin check clinics
110(2)
Screening for selected high-risk groups
112(1)
The need for better evidence
113(1)
Conclusion
114(7)
Acquired Precursor Lesions and Markers of Increased Risk for Cutaneous Melanoma
121(14)
Hensin Tsao
Arthur J. Sober
Cutaneous Pigmentation
122(1)
Hair Color and Eye Color
123(1)
Moles
123(7)
Benign (common) acquired moles
123(2)
Atypical moles
125(5)
Lentigo Maligna
130(1)
Conclusions
131(4)
Clinical Characteristics
135(28)
Allan C. Halpern
Ashfaq A. Marghoob
Arthur J. Sober
Personal History of Skin Cancer
136(1)
Clinical Presentation
136(12)
Signs and symptoms
136(5)
Clinical features
141(1)
Growth patterns
141(7)
Clinical Assessment
148(8)
History
148(1)
Physical examinations
149(1)
Diagnostic accuracy and aids to diagnosis
150(6)
Patient Education
156(1)
Primary prevention
156(1)
Skin self-examination
156(1)
New Technologies for Diagnosis
156(7)
Image analysis for diagnosis
156(1)
Multispectral imaging and automated diagnosis
157(1)
Confocal scanning laser miscroscopy
157(1)
Other techniques: Ultrasound, magnetic resonance imaging, and optical coherence tomography
157(6)
Biopsy
163(8)
Stanley J. Miller
Charles M. Balch
Preoperative Assessment
164(1)
Acceptable Biopsy Techniques
164(4)
Excisional biopsy
164(1)
Incisional biopsy
164(3)
Shave biopsy
167(1)
Saucerization
167(1)
Fine-needle aspiration
167(1)
Sentinel lymph node biopsy
167(1)
Special situations
167(1)
Summary
168(3)
Pathology
171(38)
A. Neil Crowson
Cynthia M. Magro
Raymond L. Barnhill
Martin C. Mihm, Jr.
Essential Subtypes of Melanoma
172(1)
Radial Growth Phase
172(8)
Superficial spreading melanoma
172(3)
Lentigo maligna
175(3)
Acral lentiginous melanoma
178(1)
Mucosal melanoma
179(1)
Vertical Growth Phase
180(3)
Prognostication Including Microstaging
183(3)
Level of invasion and thickness
183(2)
Other prognostic variables
185(1)
Unusual Histologic and Clinical Variants
186(10)
Desmoplastic melanoma
186(2)
Minimal deviation melanoma
188(1)
Nevoid melanoma
189(1)
Equine/animal-type melanoma in humans: Melanoma with prominent pigment synthesis
190(2)
Malignant blue nevus (melanoma arising in blue nevus)
192(1)
Metaplastic change in melanoma
192(1)
Balloon cell melanoma
192(2)
Myxoid melanoma
194(1)
Signet ring cell melanoma
194(1)
Small cell melanoma
194(1)
Other rare manifestations of the morphologic diversity of melanoma
195(1)
Melanoma in childhood
195(1)
Metastatic Melanoma
196(1)
Melanoma of Soft Parts (Clear Cell Sarcoma)
197(1)
Molecular Diagnosis of Melanoma Through Microarray Techniques
198(11)
Part III Management of Localized Melanoma
Excision of Primary Melanoma
209(22)
Merrick I. Ross
Charles M. Balch
Natale Cascinelli
Michael J. Edwards
Margins of Excision
210(1)
Historical perspective
210(1)
Randomized Surgical Trials
211(11)
The French Cooperative Group Trial (T1-T2 melanomas; ≤2 mm)
211(1)
World Health Organization Melanoma Program Trial No. 10 (T1-T2 melanomas; ≤2 mm)
211(1)
The Swedish Melanoma Trial (T1-T2 melanomas; 0.8 to 2 mm)
212(1)
The Intergroup Melanoma Surgical Trial (T2-T3 melanomas; 1 to 4 mm)
212(5)
British Cooperative Group Trial (T3-T4 melanomas; >2 mm)
217(1)
Current recommendations
218(4)
Excisions for Histologic Variants
222(1)
The diagnostic dilemma
222(1)
Desmoplastic melanoma
222(1)
Lentigo maligna melanoma
223(1)
Techniques for Routine Wound Closure
223(3)
Anatomic Considerations for Excision
226(2)
Face
226(1)
Ear
226(1)
Breast
226(1)
Digits
226(1)
Web space
227(1)
Umbilicus
228(1)
Foot
228(1)
Mohs' Surgery
228(3)
Complex Closures of Melanoma Excisions
231(32)
Maurice Nahabedian
Jeffrey D. Wagner
Principles of Reconstructive Surgery
232(1)
Assessment of the Acquired Defect
232(1)
Reconstructive Options for the Complex Wound
233(6)
Definitions
234(1)
Undermining with primary closure
234(2)
Skin grafts
236(1)
Local flaps
236(1)
Regional flaps
236(2)
Free tissue transfer
238(1)
Tissue expansion
238(1)
Complex Closures: Regional Considerations and Clinical Applications
239(24)
Head and neck
239(16)
Trunk
255(1)
Extremities
256(7)
Local Recurrences and Their Management
263(12)
Kenneth K. Tanabe
Douglas S. Reintgen
Charles M. Balch
Definition
264(1)
Mechanisms
265(1)
Risk Factors
265(2)
Surgical Margins and Local Recurrence
267(1)
Timing of Local Recurrences
268(1)
Local Recurrence and Survival
268(2)
Management
270(2)
Conclusion
272(3)
Head and Neck Melanomas
275(22)
Samuel R. Fisher
Christopher J. O'Brien
Primary Tumor Site, Patient Population, Demographics, Prognostic Factors, and Histologic Findings
277(6)
Desmoplastic Melanoma in the Head and Neck
283(3)
Recurrence Patterns
286(2)
Staging and Lymphatic Spread
288(1)
Pathways of Lymphatic Drainage
289(1)
Clinical Significance of Lymphoscintigraphic Findings
289(2)
Sentinel Lymph Node Excision
291(1)
Strategy for Treatment
292(5)
Mucosal Melanomas
297(12)
Merrick I. Ross
Scott J. Stern
Epidemiology
298(1)
Pathologic Features and Diagnosis
299(1)
Staging and Prognosis
299(1)
Mucosal Melanomas in the Head and Neck
300(3)
Epidemiology
300(1)
Clinical presentation
301(1)
Differential diagnosis
301(1)
Prognosis and natural history
302(1)
Treatment
302(1)
Mucosal Melanomas in the Female Genital Tract
303(1)
Vulvar melanoma
303(1)
Vaginal melanoma
303(1)
Treatment
304(1)
Anorectal Mucosal Melanomas
304(3)
Clinical and pathologic features
305(1)
Treatment
306(1)
Mucosal Melanomas at Other Sites
307(1)
Urinary tract
307(1)
Esophagus
307(1)
Role of Radiotherapy
307(1)
Conclusions
307(2)
Childhood Melanoma
309(10)
Caroline Bevona
Arthur J. Sober
Hensin Tsao
Epidemiology
310(1)
Congenital Melanoma
310(1)
Precursors and Risk Factors
310(3)
Giant congential nevi
310(2)
Small and medium-sized congenital nevi
312(1)
Xeroderma pigmentosum
312(1)
Constitutional risk factors
312(1)
Spitz Nevus
313(1)
Clinical Characteristics and Prognosis of Childhood Melanoma
313(2)
Surveillance and Management
315(4)
Pregnancy and Hormones
319(10)
Rona M. MacKie
Nevi and Pregnancy
320(1)
Pregnancy Before Melanoma
320(1)
Melanoma Before Pregnancy
320(1)
Melanoma During Pregnancy
321(1)
Effect of pregnancy on disease outcome
321(1)
Transplacental metastases
322(1)
Melanoma Treatment During Pregnancy
322(1)
Surgery
322(1)
Adjuvant nonsurgical therapy for pregnant women
322(1)
Chemotherapy
322(1)
Vaccine therapy and pregnancy
323(1)
Oral Contraception and Melanoma
323(1)
Use of oral contraception and subsequent melanoma risk
323(1)
Use of oral contraceptives after treatment for melanoma
323(1)
Hormone Replacement Therapy and Melanoma
324(1)
Recommendations
324(5)
Part IV Management of Regional Metastases
Lymphoscintigraphy
329(24)
John F. Thompson
Roger F. Uren
Brendon J. Coventry
Barry E. Chatterton
Lymphatic Mapping of the Skin---Early Studies
330(1)
Lymphoscintigraphy
330(1)
The first radiocolloid and early experience with lymphoscintigraphy
330(1)
Radiopharmaceuticals
330(2)
99mTechnetium-labeled colloids
330(1)
99mTc-antimony sulfide colloid
330(1)
99mTc-rhenium sulfide colloid and 99mTc-nanocolloid of albumin
331(1)
99mTc-sulfur colloid
331(1)
99mTc-human serum albumin
332(1)
What is the ideal radiocolloid?
332(1)
Lymphoscintigraphy for sentinel lymph node biopsy procedures
332(1)
The Technique of Lymphoscintigraphy
332(4)
Injecting the tracer
332(1)
Immediate dynamic imaging
333(1)
Delayed static imaging
333(1)
Marking the surface location of the sentinel node
334(1)
Radiation dosimetry
334(2)
Patterns of Lymphatic Drainage From the Skin
336(14)
Trunk
336(6)
Head and neck
342(1)
The limbs
343(3)
The definition of a sentinel node
346(1)
Interval nodes
347(1)
Drainage to multiple node fields
348(1)
Complex lymphatic drainage patterns
348(2)
Lymphoscintigraphy in clinically involved basins
350(1)
The Future
350(1)
New tracers for lymphatic mapping
350(1)
Collimators
351(1)
Gamma cameras for intraoperative imaging
351(1)
Conclusions
351(2)
Intraoperative Mapping and Sentinel Node Technology
353(26)
Douglas S. Reintgen
John F. Thompson
Jeffrey E. Gershenwald
Rationale for Lymphatic Mapping and Sentinel Lymph Node Biopsy for Melanoma
354(1)
Nodal Staging
354(3)
Elective lymph node dissection
354(1)
Intraoperative lymphatic mapping and selective lymphadenectomy
355(1)
Unusual or ambiguous drainage patterns
355(2)
Patient Selection
357(1)
Technique
358(5)
Preoperative lymphoscintigraphy
358(1)
Choice of mapping agents---radiocolloid
359(1)
Choice of vital blue dye
360(1)
Intraoperative lymphatic mapping and identification of the sentinel lymph node
361(1)
Harvesting of the sentinel lymph node
362(1)
Pathologic examination of sentinel lymph nodes
362(1)
Complications
363(1)
Reported Results
363(16)
Clinical implications
365(1)
Prognostic significance
365(2)
National trials
367(2)
RT-PCR assay results
369(1)
Molecular staging
369(3)
Training and credentialing
372(2)
National protocols
374(1)
Radiation exposure guidelines and policies
374(1)
Cost considerations
374(5)
Elective Lymph Node Dissection: Results of Prospective Randomized Surgical Trials
379(18)
Charles M. Balch
Natale Cascinelli
Franklin H. Sim
Rationale for Elective Lymphadenectomy
380(2)
The Role of Elective Lymph Node Dissection in the Staging of Melanoma
382(1)
Identifying the Regional Lymph Nodes at Risk
382(1)
Prospective Randomized Surgical Trials
383(10)
Intergroup Melanoma Surgical Trial
383(6)
The World Health Organization Melanoma Group Trials
389(4)
Mayo Clinic Surgical Trial
393(1)
Does Sentinel Lymphadenectomy Replace ELND?
393(1)
Conclusions
394(3)
Axillary and Epitrochlear Lymph Node Dissection
397(8)
Kelly M. McMasters
Sandra L. Wong
Douglas S. Tyler
Charles M. Balch
Axillary Dissection
398(5)
Anatomy
398(1)
Surgical technique
399(3)
Postoperative management
402(1)
Complications
403(1)
Epitrochlear Dissection
403(2)
Rationale
403(1)
Anatomy
403(1)
Surgical technique
403(2)
Groin and Popliteal Dissection: Technique and Complications
405(14)
Daniel G. Coit
Charles M. Balch
Groin Dissection
406(5)
Technique of superficial inguinofemoral lymph node dissection
406(5)
Iliac/Obturator (Ilioinguinal) Lymph Node Dissection
411(6)
Operative technique
412(2)
Postoperative care
414(1)
Incidence and management of postoperative complications
414(1)
Management of postoperative complications: Infection, dehiscence, skin necrosis, seroma, lymphocele, and lymphedema
415(1)
Popliteal lymphadenectomy
416(1)
Conclusions
417(2)
Neck Dissection and Parotidectomy
419(20)
Christopher J. O'Brien
Samuel R. Fisher
Irvin Pathak
Terminology
420(1)
Patterns of Metastatic Spread
421(2)
Comprehensive Neck Dissection
423(4)
Indications
423(1)
Preoperative evaluation
424(1)
Anesthesia and positioning
424(1)
Technique
424(2)
Complications
426(1)
Selective Neck Dissection
427(3)
Indications
427(1)
Technique
427(3)
Complications
430(1)
Parotidectomy
430(3)
Preoperative evaluation
431(1)
Anesthesia and positioning
431(1)
Technique
432(1)
Skin flaps
432(1)
Parotid dissection
432(1)
Complications
432(1)
Neck Dissection With Parotidectomy
433(1)
Clinical Outcome
434(1)
Adjuvant Radiation Therapy
434(5)
Recurrent Regional Metastases
439(10)
Daniel G. Coit
Cristina R. Ferrone
In Transit Metastases
440(5)
Incidence
440(1)
Treatment
441(3)
Adjuvant therapy
444(1)
Prognosis
445(1)
Recurrent Nodal Metastases After Lymph Node Dissection
445(2)
Incidence
445(1)
Treatment
446(1)
Prognosis
446(1)
Adjuvant therapy
446(1)
Conclusion
447(2)
Radiotherapy for Primary and Regional Melanoma
449(24)
Jill Ainslie
Lester J. Peters
Michael J. McKay
Primary Melanoma
450(8)
Results of curative radiotherapy alone
450(3)
Adjuvant radiotherapy following surgical excision
453(2)
Treatment recommendations
455(1)
Illustrative cases
456(2)
In Transit Metastases
458(2)
Role of radiotherapy
458(1)
Treatment recommendations
459(1)
Illustrative case
459(1)
Nodal Metastatic Melanoma
460(13)
Outcomes after lymphadenectomy alone
461(2)
Radiotherapy for unresectable nodal disease
463(1)
Adjuvant therapy for resected nodal metastatic melanoma
463(3)
Treatment recommendations
466(1)
Illustrative cases
467(6)
Hyperthermic Regional Perfusion for Melanoma of the Limbs
473(22)
Douglas L. Fraker
Alexander M. M. Eggermont
Epidemiology and Natural History
474(1)
Clinical Series
475(2)
Adjuvant Isolated Limb Perfusion
477(2)
Therapeutic Limb Perfusion With Melphalan
479(2)
Pharmacokinetics of Melphalan in Isolated Limb Perfusion
481(1)
Isolated Limb Perfusion With Other Chemotherapeutic Agents
482(1)
Use of Tumor Necrosis Factor in Isolated Limb Perfusion
483(5)
Toxicity of Isolated Limb Perfusion
488(1)
Technical Aspects of Isolated Limb Perfusion
489(6)
Isolated Limb Infusion
495(16)
John F. Thompson
Peter C.A. Kam
Per Lindner
Johannes H.W. de Wilt
Similarities and Differences Between Isolated Limb Infusion and Conventional Isolated Limb Perfusion
496(1)
Patient Selection for Isolated Limb Infusion
496(1)
Technical Details of the Isolated Limb Infusion Procedure
496(5)
Preoperative assessment and management
496(1)
Insertion and positioning of arterial and venous catheters
497(1)
Procedure in the operating room
498(2)
Postoperative care
500(1)
Tumor Responses After Isolated Limb Infusion
501(1)
Clinical Results of Isolated Limb Infusion
501(1)
Factors Predicting Outcome After Isolated Limb Infusion
502(1)
Patient-related factors
502(1)
Intraoperative factors
502(1)
Limb temperatures during isolated limb infusion
502(1)
Tourniquet times
502(1)
Interpretation of prognostic factors data
503(1)
Melphalan Concentrations During Isolated Limb Infusion
503(1)
Limb Toxicity After Isolated Limb Infusion
504(1)
Repeat Isolated Limb Infusion Procedures
504(1)
Elective repeat isolated limb infusion
504(1)
Repeat isolated limb infusion for disease progression after a first isolated limb infusion
504(1)
Laboratory Studies of Isolated Limb Infusion
505(1)
Use of Microdialysis to Monitor Drug Concentrations in Limb Tissues and Tumor Deposits During Isolated Limb Infusion
505(1)
Advantages and Disadvantages of Isolated Limb Infusion Compared With Isolated Limb Perfusion
505(1)
Potential Use of the Isolated Limb Infusion Technique to Evaluate Other Drugs and Biological Agents
505(6)
Part V Diagnosis and Local Treatment of Distant Metastases
Metastatic Surveillance and Follow-Up
511(12)
Daniel G. Coit
Cristina R. Ferrone
Detection of Recurrence
512(1)
Patient Education
513(1)
Detection of a Second Primary Melanoma
513(1)
Screening for Other Primary Malignancies
513(1)
Identification of Family Kindreds
513(1)
Psychosocial Support
513(1)
Documentation of End Results
514(1)
Current Practice
514(1)
Pattern of Recurrence
514(1)
Time Course to Recurrence
514(2)
Role of Physical Examination
516(1)
Role of Laboratory Tests
516(1)
Radiology
517(1)
What Is Known About Current Practice
517(2)
Summary and Conclusions
519(4)
Diagnosis of Stage IV Disease
523(24)
Wen-jen Hwu
Charles M. Balch
Alan N. Houghton
Timing of Distant Metastasis
524(1)
Late Recurrence
524(1)
Pattern of Metastasis
524(1)
Prognosis and Prognostic Factors
525(3)
Sites of distant metastases
526(1)
Number of metastatic sites
526(1)
Duration of remission
526(1)
Other prognostic factors
527(1)
Clinical Evaluation of Metastasis
528(4)
History and physical examination
528(1)
Laboratory tests
528(1)
Radiologic tests
528(1)
Radionuclide scans
529(1)
Positron emission tomography scans
529(1)
Pathologic tests
530(1)
Radiolabeled monoclonal antibodies
531(1)
Polymerase chain reaction
531(1)
Sites of Distant Metastases
532(6)
Skin, subcutaneous tissues, and distant lymph nodes
532(1)
Lung, pleura, and mediastinum
532(1)
Brain and spinal cord
533(1)
Gastrointestinal tract
534(1)
Liver, biliary tract, and spleen
535(1)
Bone
535(1)
Kidneys and urinary tract
536(1)
Other sites
536(2)
Melanosis
538(1)
Metastatic Melanoma From an Unknown Primary Site
538(1)
Surveillance in Patients Who Have Localized Melanoma
539(8)
Surgical Excision of Distant Metastases
547(26)
Donald L. Morton
Richard Essner
Charles M. Balch
Current Status of Surgery for Distant Metastases
548(2)
Site-Specific Organ Metastasis
550(1)
Surgical vs. Nonsurgical Cytoreduction
551(1)
Cytotoxic systemic agents
551(1)
Cytoreductive surgery
551(1)
Relationship Between Tumor Burden, Immune Function, and Surgical Therapy
551(2)
Selection of Patients and Prognostic Factors
553(3)
Surgical Principles and Outcomes for Metastases at Specific Sites
556(11)
Skin, subcutaneous tissue, and lymph nodes
556(1)
Lung, trachea, and bronchi
556(3)
Brain and spinal cord
559(2)
Gastrointestinal tract
561(2)
Liver, biliary tract, and spleen
563(1)
Bone
564(1)
Kidney and urinary tract
565(1)
Heart and pericardium
565(1)
Endocrine organs
565(1)
Breast
566(1)
Ovaries, uterus, and vagina
566(1)
Testes and penis
567(1)
Oral cavity and pharynx
567(1)
Eye
567(1)
Summary
567(6)
Radiotherapy for Distant Metastases and Clinical Radiobiology of Melanoma
573(16)
Michael J. McKay
Lester J. Peters
Jill Ainslie
Radiotherapy for Distant Metastases
574(4)
Skin, subcutaneous, and distant lymph node metastases
574(1)
Brain metastases
574(1)
Malignant spinal cord compression
575(1)
Bone metastases
576(1)
Selected intrathoracic and intra-abdominal metastases
576(1)
Uncommon metastatic sites
576(1)
Illustrative case
576(2)
Clinical Radiobiology
578(11)
Biological factors affecting the ionizing radiation response of melanoma
578(1)
Tumor factors
578(5)
Host factors
583(1)
Past experience and future possibilities
583(6)
Part VI Systemic Treatment of Metastatic Disease
Chemotherapy and Biochemotherapy
589(16)
Michael B. Atkins
Antonio C. Buzaid
Alan N. Houghton
Single-Agent Chemotherapy
590(2)
Dacarbazine and temozolomide
590(1)
Nitrosoureas
591(1)
Platinums
591(1)
Other agents
591(1)
Combination Chemotherapy
592(1)
Nitrosourea and DTIC-based combination therapy
592(1)
Taxane-based combination therapy
593(1)
Cisplatin-based combination therapy
593(1)
Chemohormonal Therapy
593(1)
Biochemotherapy
594(7)
Interferon-alpha-based biochemotherapy regimens
594(1)
Interleukin-2-based biochemotherapy regimens
595(6)
Conclusions
601(4)
Interferons and Adjuvant Therapy
605(18)
Sanjiv S. Agarwala
John M. Kirkwood
Chemotherapy
606(1)
Microbial Immunostimulants
607(2)
Bacillus Calmette-Guerin
607(1)
Corynebacterium parvum
608(1)
Levamisole
609(1)
Hormonal Therapy
609(1)
Interferons
610(7)
Adjuvant applications of interferon-alpha-2
610(7)
Adjuvant applications of interferon-gamma
617(1)
Vaccines
617(2)
Multivalent vaccines: Whole cell, Iysate, and shed antigens
617(1)
Univalent vaccines: Carbohydrate antigen and peptide vaccines
618(1)
Conclusions
619(4)
Interleukins
623(22)
Douglas J. Schwartzentruber
Steven A. Rosenberg
Interleukin-2
624(2)
Pharmacology of interleukin-2
624(1)
Immunologic activity of interleukin-2
624(1)
Systemic effects of interleukin-2
625(1)
Alternative Routes and Doses of Interleukin-2 Administration
626(1)
Clinical Efficacy of Interleukin-2 Alone
626(5)
Clinical Efficacy of Interleukin-2 Combined With Interferon-alpha
631(1)
Clinical Efficacy of Interleukin-2 Combined With Other Cytokines, Immune Modulators, or Antibodies
631(1)
Clinical Efficacy of Interleukin-2 Combined With Cellular Therapy
631(4)
Agents to Reduce Toxicity
635(1)
Predictors of Clinical Response
635(1)
Other Cytokines for Therapy of Metastatic Melanoma
636(1)
Conclusions
636(9)
Melanoma Vaccines
645(14)
Jedd D. Wolchok
Jeffrey S. Weber
Alan N. Houghton
Philip O. Livingston
Types of Antigens
646(1)
Allogeneic Vaccines
646(2)
Autologous Vaccines
648(1)
Defined Antigen Vaccines: Ganglioside Antigens
648(1)
Anti-Idiotypic Monoclonal Antibodies Mimicking Ganglioside Antigens
649(1)
Protein Antigens
650(1)
DNA Vaccination
651(1)
Dendritic Cells
652(1)
Heat-Shock Proteins
653(1)
Recombinant Viral Vaccines
653(1)
Conclusion
653(6)
Part VII Biology of Melanoma
Immunology
659(10)
Alan N. Houghton
Fedd D. Wolchok
Innate Immunity
660(1)
Adaptive Immunity
661(1)
Melanoma and Cancer Immunology
661(1)
Melanoma Antigens
661(5)
Cancer/testis antigens
664(1)
Differentiation antigens
664(1)
Experimental models
665(1)
Therapy
666(1)
Conclusion
667(2)
Melanoma Antigens and Their Use as Vaccines
669(18)
Paul F. Robbins
Steven A. Rosenberg
Cloning and Characterization of Tumor Antigens
672(4)
MHC class I and class II restricted antigen recognition
672(1)
Antigens recognized by class I restricted, tumor-reactive T cells
673(2)
Antigens recognized by class II restricted, tumor-reactive T cells
675(1)
Antigen Processing and Presentation in Tumor Cells
676(2)
Cancer Vaccine Clinical Trials
678(4)
Rationale
678(1)
Clinical observations
679(3)
Future Directions
682(5)
Genetics and Molecular Staging
687(26)
Pamela M. Pollock
Ashani Weeraratna
Jeffrey M. Trent
Hereditary Basis of Melanoma Genesis and Progression
689(10)
Genes involved in melanoma susceptibility
689(7)
Genes implicated in sporadic melanoma development
696(3)
Molecular Pathology of Melanoma
699(14)
Chromosomal regions implicated in sporadic melanoma
699(3)
Generating gene expression profiles of melanoma
702(4)
Molecular staging of melanoma metastases
706(7)
Molecular and Cellular Biology
713(40)
Thomas Bogenrieder
David E. Elder
Meenhard Herlyn
Normal Skin Homeostasis and Melanoma Development
714(2)
The human pigmentary system: The epidermal melanin unit
715(1)
Melanoma development is a multistep process
715(1)
Cell Cycle Regulators
716(4)
Selected components of the cell cycle machinery
716(1)
Alterations of the primary retinoblastoma pathway in melanoma
717(1)
p16INK4A/p14ARF in primary specimens
717(1)
p16 and familial melanoma
718(1)
p15INK4B
718(1)
Expression and prognostic relevance of cyclins/Cdk/CKIs in melanoma
718(1)
p53 tumor suppressor and melanoma
719(1)
c-Myc
720(1)
Telomerase: Limitless Replicative Potential and Immortalization
720(1)
Evading Apoptosis
721(1)
Selective components of the apoptotic program
721(1)
Defects of the apoptotic program in melanoma
721(1)
Apaf-1
721(1)
Survivin and TRAIL
722(1)
Growth Signaling Pathways
722(5)
Mitogen-activated protein kinase signal transduction pathways
722(1)
Ras-Raf-MEK-MAP kinase pathway
722(2)
Ras genes and melanoma
724(1)
Rho GTPases and melanoma: Mediators of metastasis?
725(1)
MEKK1/p38 stress-activated protein kinase pathway
725(1)
Stem cell factor/c-Kit signaling pathway
725(1)
Hepatocyte growth factor/scatter factor/c-Met tyrosine kinase receptor
725(1)
PTEN and the phosphatidylinositol 3-kinase (P13 kinase)/Akt signaling pathway
726(1)
Transcription Factors in Melanocyte Biology
727(2)
AP-2: A ``master switch'' to regulate c-Kit and MCAM expression
727(1)
Activating transcription factor-1 and cAMP response element-binding protein
727(1)
Microphthalmia-associated transcription factor
728(1)
Paired-box gene 3
728(1)
Growth Factors and Cytokines: Heterotypic Signaling
729(3)
Basic fibroblast growth factor, vascular endothelial cell growth factor, and plateletderived growth factor
729(1)
Insulin-like growth factor-1
730(1)
Transforming growth factor-β
730(1)
Interleukin-6
731(1)
Chemokines/chemokine receptors
731(1)
Endothelins and endothelin receptor B
732(1)
Cell-Cell Interactions and Adhesion Molecules
732(4)
Integrins in melanoma progression
733(1)
Cell adhesion molecules of the immunoglobin superfamily
733(1)
Cadherin expression and function: Cadherin class switching
734(1)
Signaling pathways of E-cadherin: β-catenin and the Wnt/Frizzled pathway
735(1)
Ephrins and Eph receptors: Control of cell behavior by intercellular communication
735(1)
Cell Surface Proteolysis and Manipulation of the Microenvironment
736(2)
Angiogenesis and vasculogenic mimicry
736(1)
Invasion and metastasis: Matrix metalloproteinases (MMPs/matrixins)
736(1)
Cell surface peptidases (DPPIV/CD26, APN/CD13, and NEP/CD10)
737(1)
Redox Regulation in Melanocytes and Melanoma
738(1)
Synthesis and Perspectives
738(15)
Biology of Melanoma Metastasis
753(26)
Isaiah J. Fidler
The Pathogenesis of Melanoma Metastasis
754(6)
Initial growth of cutaneous melanomas and angiogenesis
754(3)
Tumor cell invasion
757(1)
Tumor cell survival in the circulation
758(1)
Tumor cell arrest, adhesion, and extravasation
759(1)
Evolution of Primary Melanomas
760(1)
Biological Heterogeneity of Primary Melanomas and Their Metastases
761(4)
Enhanced metastatic potential of tumor cells harvested from spontaneous metastases of melanoma
764(1)
Metastasis of metastases
764(1)
Clonal Origin of Melanoma Metastases
765(1)
Generation of Biological Diversity Within a Metastasis
765(1)
Predominance of the Metastatic Phenotype
766(1)
Role of the Organ Microenvironment in the Pathogenesis of Metastasis
766(3)
Experimental and clinical evidence
766(2)
Blood-brain barrier and melanoma metastasis
768(1)
Antiangiogenesis-Antimetastasis Therapy
769(1)
Conclusions
769(10)
Additional Credits 779(2)
Index 781

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