PURPOSE OF REVIEW: Ulceration of a primary cutaneous melanoma has for many years been recognized as a very important prognostic factor associated with increased risk for recurrence and mortality. Patients with an ulcerated melanoma do much worse than patients with a nonulcerated melanoma with the same breslow thickness. Ulceration may indicate a separate biologic entity. RECENT FINDINGS: Gene profiling studies of fresh frozen melanoma samples indicated that ulcerated melanomas have a very different profile. Analysis of the results of the two largest adjuvant interferon (IFN) trials ever conducted in 2644 patients [European Organization for Research and Treatment of Cancer (EORTC) 18952 and 18991], which used ulceration of the primary as a stratification factor, indicated that ulceration was not only a very strong prognostic factor, but more importantly a significant predictive factor for outcome of adjuvant IFN treatment. Only in patients with an ulcerated primary, was a similar and significant impact on disease-free survival, distant metastasis-free survival and overall survival observed. As a more general finding, in trials independent of ulceration used as a stratification factor, this IFN sensitivity of ulcerated melanomas has been reported in a meta-analysis in more than 3000 patients. It was also identified as a predictive factor of outcome in the Sunbelt adjuvant IFN trial in the USA. SUMMARY: These important findings regarding ulceration need biologic studies to identify the differences between ulcerated and nonulcerated melanoma at the molecular level. Moreover, the importance of ulceration will be assessed prospectively in the EORTC 18081 trial in patients with primary ulcerated melanomas more than 1 mm.
PURPOSE OF REVIEW: Ulceration of a primary cutaneous melanoma has for many years been recognized as a very important prognostic factor associated with increased risk for recurrence and mortality. Patients with an ulcerated melanoma do much worse than patients with a nonulcerated melanoma with the same breslow thickness. Ulceration may indicate a separate biologic entity. RECENT FINDINGS: Gene profiling studies of fresh frozen melanoma samples indicated that ulcerated melanomas have a very different profile. Analysis of the results of the two largest adjuvant interferon (IFN) trials ever conducted in 2644 patients [European Organization for Research and Treatment of Cancer (EORTC) 18952 and 18991], which used ulceration of the primary as a stratification factor, indicated that ulceration was not only a very strong prognostic factor, but more importantly a significant predictive factor for outcome of adjuvant IFN treatment. Only in patients with an ulcerated primary, was a similar and significant impact on disease-free survival, distant metastasis-free survival and overall survival observed. As a more general finding, in trials independent of ulceration used as a stratification factor, this IFN sensitivity of ulcerated melanomas has been reported in a meta-analysis in more than 3000 patients. It was also identified as a predictive factor of outcome in the Sunbelt adjuvant IFN trial in the USA. SUMMARY: These important findings regarding ulceration need biologic studies to identify the differences between ulcerated and nonulcerated melanoma at the molecular level. Moreover, the importance of ulceration will be assessed prospectively in the EORTC 18081 trial in patients with primary ulcerated melanomas more than 1 mm.
Authors: Ellen H de Moll; Yichun Fu; Yingzhi Qian; Sara H Perkins; Shira Wieder; Sacha Gnjatic; Romain Remark; Sebastian G Bernardo; Marina Moskalenko; Jonathan Yao; Tammie Ferringer; Rui Chang; Jerry Chipuk; Basil A Horst; Miriam B Birge; Robert G Phelps; Yvonne M Saenger Journal: Cancer Immunol Immunother Date: 2015-06-16 Impact factor: 6.968
Authors: Alexander M M Eggermont; Vanna Chiarion-Sileni; Jean-Jacques Grob; Reinhard Dummer; Jedd D Wolchok; Henrik Schmidt; Omid Hamid; Caroline Robert; Paolo A Ascierto; Jon M Richards; Céleste Lebbé; Virginia Ferraresi; Michael Smylie; Jeffrey S Weber; Michele Maio; Lars Bastholt; Laurent Mortier; Luc Thomas; Saad Tahir; Axel Hauschild; Jessica C Hassel; F Stephen Hodi; Corina Taitt; Veerle de Pril; Gaetan de Schaetzen; Stefan Suciu; Alessandro Testori Journal: N Engl J Med Date: 2016-10-07 Impact factor: 91.245
Authors: Meng Qian; Michelle W Ma; Nathaniel H Fleming; Daniel J Lackaye; Eva Hernando; Iman Osman; Yongzhao Shao Journal: Melanoma Res Date: 2013-12 Impact factor: 3.599
Authors: Rosalyn Jewell; Faye Elliott; Jonathan Laye; Jérémie Nsengimana; John Davies; Christy Walker; Caroline Conway; Angana Mitra; Mark Harland; Martin G Cook; Andy Boon; Sarah Storr; Sabreena Safuan; Stewart G Martin; Karin Jirström; Håkan Olsson; Christian Ingvar; Martin Lauss; Tim Bishop; Göran Jönsson; Julia Newton-Bishop Journal: Pigment Cell Melanoma Res Date: 2014-10-01 Impact factor: 4.693
Authors: John R Davies; Rosalyn Jewell; Paul Affleck; Gabriella M Anic; Juliette Randerson-Moor; Aija Ozola; Kathleen M Egan; Faye Elliott; Zaida García-Casado; Johan Hansson; Mark Harland; Veronica Höiom; Guan Jian; Göran Jönsson; Rajiv Kumar; Eduardo Nagore; Judith Wendt; Håkan Olsson; Jong Y Park; Poulam Patel; Dace Pjanova; Susana Puig; Dirk Schadendorf; P Sivaramakrishna Rachakonda; Helen Snowden; Alexander J Stratigos; Dimitrios Bafaloukos; Zighereda Ogbah; Antje Sucker; Joost J Van den Oord; Remco Van Doorn; Christy Walker; Ichiro Okamoto; Pascal Wolter; Jennifer H Barrett; D Timothy Bishop; Julia Newton-Bishop Journal: Int J Cancer Date: 2014-03-06 Impact factor: 7.396