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The Role of Electrochemotherapy in the Treatment of Malignant Melanoma

Mecker G. Möller,S. Salwa,D. Soden,G. O'sullivan

Published 2011 in Unknown venue

ABSTRACT

About 68,130 new melanomas will be diagnosed in the United States during 2010 (38,870 men: 29,260 women) and of those 8,700 people will die of the disease (5,670 men; 3,030 women). The death rate has been dropping since the 1990s for those younger than 50, but has remained stable or is rising for older individuals. However, the incidence of melanoma has been increasing for at least 30 years, and this trend has become more pronounced in young white females and in older white men1. Malignant Melanoma is the seventh most common type of cancer, but it is the first cause of death from cutaneous skin cancers2. It has been estimated that the lifetime risk of developing malignant melanoma is 2% (1 in 50) for Caucasians, 0.1% (1 in 1,000) for those of black descent, and 0.5% (1 in 200) for Hispanics3 . When melanoma is detected in advanced stages, it carries a dismal prognosis, with a mean survival of about 8 months and a 5-year survival as low as 5% 4-6. The disease spreads both by the lymphogenous and the haematogenous routes and can metastasize to virtually any organ in the body. When secondary tumours emerge, these usually follow a sequential pattern to regional lymph node basins, followed by distant sites including skin, subcutaneous tissue, lung, liver, brain, bone and other viscera5-6. Local recurrence, intransit metastases and satellitosis (cutaneous metastases within 2 cm of original lesion) represent the same dissemination process4 in the dermal lymphatics. When the patients present with cutaneous metastases, they are considered to have stage IIIB disease7. Cutaneous metastases occur in 2-20% of patients, depending on tumor thickness 6, 8-9 and can occur either during the early or late phase of the disease 10. In many instances they can represent the first site of recurrence after surgical excision of the primary tumor 11 . The majority (70-80%) of recurrences are diagnosed within the first 3 years of initial diagnosis, and the median time to the presence of in-transit disease could range between 3 to 16 months4. The recurrences present as local or in-transit disease in 20-28%, regional disease in 26-60% and as distant metastases in 15-50% of patients. Even though local recurrence is

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