Publication date: Aug 14, 2019
Recently the 8th version of the American Joint Committee on Cancer (AJCC) classification has been introduced, and has attempted to define a more accurate and precise definition of prognosis in line with the major progresses in understanding the biology and pathogenesis of melanoma. This new staging system introduces major changes in the stage III staging system. Indeed, surgical practice is changing in stage III patients, since, according to recent evidence, there is no survival benefit in radical lymph node dissection following a positive sentinel lymph node dissection. Therefore, some patients currently staged IIIB-C after dissection could be downgraded to IIIA (as in the case of patients with metastatic non-sentinel lymph nodes) since many completion lymph node dissections will no longer be performed. Moreover, new and effective targeted and immune strategies are being introduced in the pharmacological armamentarium in the adjuvant setting, showing major efficacy.
This article provides the authors’ personal view on the above-mentioned topics.
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Ascierto, P.A., Borgognoni, L., Botti, G., Guida, M., Marchetti, P., Mocellin, S., Muto, P., Palmieri, G., Patuzzo, R., Quaglino, P., and , Stanganelli. New paradigm for stage III melanoma: from surgery to adjuvant treatment. 23773. 2019 J Transl Med (17):1.
- Adjuvant ipilimumab versus placebo after complete resection of stage III melanoma: long-term follow-up results of the European Organisation for Research and Treatment of Cancer 18071 double-blind phase 3 randomised trial.