Melanoma Clinical Practice Guidelines in Oncology
NCCN Categories of Evidence and Consensus
Category 1: The recommendation is based on high-level evidence (e.g., randomized controlled trials) and there is uniform NCCN consensus.
Category 2A: The recommendation is based on lower-level evidence and there is uniform NCCN consensus.
Category 2B: The recommendation is based on lower-level evidence and there is nonuniform NCCN consensus (but no major disagreement).
Category 3: The recommendation is based on any level of evidence but reflects major disagreement.
All recommendations are category 2A unless otherwise noted.
Clinical trials: The NCCN believes that the best management for any cancer patient is in a clinical trial. Participation in clinical trials is especially encouraged.
In 2008, an estimated 62,480 new cases of melanoma will have been diagnosed and approximately 8420 patients will have died of the disease in the United States.1 However, these projections for new cases may represent a substantial underestimation, because many superficial and in situ melanomas treated in the outpatient setting are not reported. The incidence of melanoma continues to increase dramatically. Melanoma is increasing in men more rapidly than any other malignancy and more rapidly in women than any other malignancy except lung cancer. For someone born in the United States in 2005, the lifetime risk for developing melanoma may be as high as 1 in 55.2 Melanoma ranks second to adult leukemia in terms of loss of years of potential life, per death. The median age at diagnosis is 59 years.
Risk factors for melanoma include...
Surveillance Epidemiology and End Results. SEER stats fact sheet. Available at: http://seer.cancer.gov/statfacts/html/melan. html#ref11. Accessed 8 December 2008.
Surveillance Epidemiology and End Results. SEER stats fact sheet. Available at: http://seer.cancer.gov/statfacts/html/melan. html#ref11. Accessed 8 December 2008.
)| false
JensenEHMargolinKASondakVK. Melanoma and other skin cancers. In: PazdurRCoiaLHoskinsWJWagmanLD eds. Cancer Management: A Multidisciplinary Approach9th edition. New York: CMP Media; 2005:531–562.
JensenEHMargolinKASondakVK. Melanoma and other skin cancers. In: PazdurRCoiaLHoskinsWJWagmanLD, eds. Cancer Management: A Multidisciplinary Approach, 9th edition. New York: CMP Media; 2005:531–562.
)| false
BalchCMBuzaidACSoongSJ. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol2001;19:3635–3648.
BalchCMBuzaidACSoongSJ. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol2001;19:3635–3648.
)| false
BalchCMSoongSJGershenwaldJE. Prognostic factors analysis of 17,600 melanoma patients: validation of the American Joint Committee on Cancer melanoma staging system. J Clin Oncol2001;19:3622–3634.
BalchCMSoongSJGershenwaldJE. Prognostic factors analysis of 17,600 melanoma patients: validation of the American Joint Committee on Cancer melanoma staging system. J Clin Oncol2001;19:3622–3634.
)| false
BarnhillRLKatzenJSpatzA. The importance of mitotic rate as a prognostic factor for localized cutaneous melanoma. J Cutan Pathol2005;32:268–273.
BarnhillRLKatzenJSpatzA. The importance of mitotic rate as a prognostic factor for localized cutaneous melanoma. J Cutan Pathol2005;32:268–273.
)| false
AzzolaMFShawHMThompsonJF. Tumor mitotic rate is a more powerful prognostic indicator than ulceration in patients with primary cutaneous melanoma: an analysis of 3661 patients from a single center. Cancer2003;97:1488–1498.
AzzolaMFShawHMThompsonJF. Tumor mitotic rate is a more powerful prognostic indicator than ulceration in patients with primary cutaneous melanoma: an analysis of 3661 patients from a single center. Cancer2003;97:1488–1498.
)| false
FranckenABShawHMThompsonJF. The prognostic importance of tumor mitotic rate confirmed in 1317 patients with primary cutaneous melanoma and long follow-up. Ann Surg Oncol2004;11:426–433.
FranckenABShawHMThompsonJF. The prognostic importance of tumor mitotic rate confirmed in 1317 patients with primary cutaneous melanoma and long follow-up. Ann Surg Oncol2004;11:426–433.
)| false
GimottyPAElderDEFrakerDL. Identification of high-risk patients among those diagnosed with thin cutaneous melanomas. J Clin Oncol2007;25:1129–1134.
GimottyPAElderDEFrakerDL. Identification of high-risk patients among those diagnosed with thin cutaneous melanomas. J Clin Oncol2007;25:1129–1134.
)| false
PaekSCGriffithKAJohnsonTM. The impact of factors beyond Breslow depth on predicting sentinel lymph node positivity in melanoma. Cancer2007;109:100–108.
PaekSCGriffithKAJohnsonTM. The impact of factors beyond Breslow depth on predicting sentinel lymph node positivity in melanoma. Cancer2007;109:100–108.
)| false
SondakVKTaylorJMSabelMS. Mitotic rate and younger age are predictors of sentinel lymph node positivity: lessons learned from the generation of a probabilistic model. Ann Surg Oncol2004;11:247–258.
SondakVKTaylorJMSabelMS. Mitotic rate and younger age are predictors of sentinel lymph node positivity: lessons learned from the generation of a probabilistic model. Ann Surg Oncol2004;11:247–258.
)| false
CascinelliNBelliFSantinamiM. Sentinel lymph node biopsy in cutaneous melanoma: the WHO Melanoma Program experience. Ann Surg Oncol2000;7:469–474.
CascinelliNBelliFSantinamiM. Sentinel lymph node biopsy in cutaneous melanoma: the WHO Melanoma Program experience. Ann Surg Oncol2000;7:469–474.
)| false
WangTSJohnsonTMCascadePN. Evaluation of staging chest radiographs and serum lactate dehydrogenase for localized melanoma. J Am Acad Dermatol2004;51:399–405.
WangTSJohnsonTMCascadePN. Evaluation of staging chest radiographs and serum lactate dehydrogenase for localized melanoma. J Am Acad Dermatol2004;51:399–405.
)| false
AloiaTAGershenwaldJEAndtbackaRH. Utility of computed tomography and magnetic resonance imaging staging before completion lymphadenectomy in patients with sentinel lymph node-positive melanoma. J Clin Oncol2006;24:2858–2865.
AloiaTAGershenwaldJEAndtbackaRH. Utility of computed tomography and magnetic resonance imaging staging before completion lymphadenectomy in patients with sentinel lymph node-positive melanoma. J Clin Oncol2006;24:2858–2865.
)| false
GoldJSJaquesDPBusamKJ. Yield and predictors of radiologic studies for identifying distant metastases in melanoma patients with a positive sentinel lymph node biopsy. Ann Surg Oncol2007;14:2133–2140.
GoldJSJaquesDPBusamKJ. Yield and predictors of radiologic studies for identifying distant metastases in melanoma patients with a positive sentinel lymph node biopsy. Ann Surg Oncol2007;14:2133–2140.
)| false
BuzaidACTinocoLRossMI. Role of computed tomography in the staging of patients with local-regional metastases of melanoma. J Clin Oncol1995;13:2104–2108.
BuzaidACTinocoLRossMI. Role of computed tomography in the staging of patients with local-regional metastases of melanoma. J Clin Oncol1995;13:2104–2108.
)| false
JohnsonTMFaderDJChangAE. Computed tomography in staging of patients with melanoma metastatic to the regional nodes. Ann Surg Oncol1997;4:396–402.
JohnsonTMFaderDJChangAE. Computed tomography in staging of patients with melanoma metastatic to the regional nodes. Ann Surg Oncol1997;4:396–402.
)| false
ClarkPBSooVKraasJ. Futility of fluorodeoxyglucose F 18 positron emission tomography in initial evaluation of patients with T2 to T4 melanoma. Arch Surg2006;141:284–288.
ClarkPBSooVKraasJ. Futility of fluorodeoxyglucose F 18 positron emission tomography in initial evaluation of patients with T2 to T4 melanoma. Arch Surg2006;141:284–288.
)| false
MaubecELumbrosoJMassonF. F-18 fluorodeoxy-D-glucose positron emission tomography scan in the initial evaluation of patients with a primary melanoma thicker than 4 mm. Melanoma Res2007;17:147–154.
MaubecELumbrosoJMassonF. F-18 fluorodeoxy-D-glucose positron emission tomography scan in the initial evaluation of patients with a primary melanoma thicker than 4 mm. Melanoma Res2007;17:147–154.
)| false
National Institutes of Health. After treatment of early melanoma, should patients and family members be followed? Why and How?NIH Consensus Statement1992;10:1–26.
National Institutes of Health. After treatment of early melanoma, should patients and family members be followed? Why and How?NIH Consensus Statement1992;10:1–26.
)| false
VeronesiUCascinelliNAdamusJ. Thin stage I primary cutaneous malignant melanoma. Comparison of excision with margins of 1 or 3 cm. N Engl J Med1988;318:1159–1162.
VeronesiUCascinelliNAdamusJ. Thin stage I primary cutaneous malignant melanoma. Comparison of excision with margins of 1 or 3 cm. N Engl J Med1988;318:1159–1162.
)| false
BalchCMSoongSJSmithT. Long-term results of a prospective surgical trial comparing 2 cm vs. 4 cm excision margins for 740 patients with 1-4 mm melanomas. Ann Surg Oncol2001;8:101–108.
BalchCMSoongSJSmithT. Long-term results of a prospective surgical trial comparing 2 cm vs. 4 cm excision margins for 740 patients with 1-4 mm melanomas. Ann Surg Oncol2001;8:101–108.
)| false
BalchCMUristMMKarakousisCP. Efficacy of 2-cm surgical margins for intermediate-thickness melanomas (1 to 4 mm). Results of a multi-institutional randomized surgical trial. Ann Surg1993;218:262–267; discussion 267–269.
BalchCMUristMMKarakousisCP. Efficacy of 2-cm surgical margins for intermediate-thickness melanomas (1 to 4 mm). Results of a multi-institutional randomized surgical trial. Ann Surg1993;218:262–267; discussion 267–269.
)| false
Cohn-CedermarkGRutqvistLEAnderssonR. Long term results of a randomized study by the Swedish Melanoma Study Group on 2-cm versus 5-cm resection margins for patients with cutaneous melanoma with a tumor thickness of 0.8-2.0 mm. Cancer2000;89:1495–1501.
Cohn-CedermarkGRutqvistLEAnderssonR. Long term results of a randomized study by the Swedish Melanoma Study Group on 2-cm versus 5-cm resection margins for patients with cutaneous melanoma with a tumor thickness of 0.8-2.0 mm. Cancer2000;89:1495–1501.
)| false
KhayatDRixeOMartinG. Surgical margins in cutaneous melanoma (2 cm versus 5 cm for lesions measuring less than 2.1-mm thick). Cancer2003;97:1941–1946.
KhayatDRixeOMartinG. Surgical margins in cutaneous melanoma (2 cm versus 5 cm for lesions measuring less than 2.1-mm thick). Cancer2003;97:1941–1946.
)| false
HaighPIDiFronzoLAMcCreadyDR. Optimal excision margins for primary cutaneous melanoma: a systematic review and meta-analysis. Can J Surg2003;46:419–426.
HaighPIDiFronzoLAMcCreadyDR. Optimal excision margins for primary cutaneous melanoma: a systematic review and meta-analysis. Can J Surg2003;46:419–426.
)| false
JohnsonTMHeadingtonJTBakerSRLoweL. Usefulness of the staged excision for lentigo maligna and lentigo maligna melanoma: the ”square” procedure. J Am Acad Dermatol1997;37:758–764.
JohnsonTMHeadingtonJTBakerSRLoweL. Usefulness of the staged excision for lentigo maligna and lentigo maligna melanoma: the ”square” procedure. J Am Acad Dermatol1997;37:758–764.
)| false
JohnsonTMSondakVKBichakjianCKSabelMS. The role of sentinel lymph node biopsy for melanoma: evidence assessment. J Am Acad Dermatol2006;54:19–27.
JohnsonTMSondakVKBichakjianCKSabelMS. The role of sentinel lymph node biopsy for melanoma: evidence assessment. J Am Acad Dermatol2006;54:19–27.
)| false
MortonDLCochranAJThompsonJF. Sentinel node biopsy for early-stage melanoma: accuracy and morbidity in MSLT-I, an international multicenter trial. Ann Surg2005;242:302–311; discussion 311–303.
MortonDLCochranAJThompsonJF. Sentinel node biopsy for early-stage melanoma: accuracy and morbidity in MSLT-I, an international multicenter trial. Ann Surg2005;242:302–311; discussion 311–303.
)| false
FerroneCRPanageasKSBusamK. Multivariate prognostic model for patients with thick cutaneous melanoma: importance of sentinel lymph node status. Ann Surg Oncol2002;9:637–645.
FerroneCRPanageasKSBusamK. Multivariate prognostic model for patients with thick cutaneous melanoma: importance of sentinel lymph node status. Ann Surg Oncol2002;9:637–645.
)| false
GershenwaldJEMansfieldPFLeeJERossMI. Role for lymphatic mapping and sentinel lymph node biopsy in patients with thick (> or = 4 mm) primary melanoma. Ann Surg Oncol2000;7:160–165.
GershenwaldJEMansfieldPFLeeJERossMI. Role for lymphatic mapping and sentinel lymph node biopsy in patients with thick (> or = 4 mm) primary melanoma. Ann Surg Oncol2000;7:160–165.
)| false
GutzmerRSatzgerIThomsKM. Sentinel lymph node status is the most important prognostic factor for thick (> or = 4 mm) melanomas. J Dtsch Dermatol Ges2008;6:198–203.
GutzmerRSatzgerIThomsKM. Sentinel lymph node status is the most important prognostic factor for thick (> or = 4 mm) melanomas. J Dtsch Dermatol Ges2008;6:198–203.
)| false
GlassFLCottamJAReintgenDSFenskeNA. Lymphatic mapping and sentinel node biopsy in the management of high-risk melanoma. J Am Acad Dermatol1998;39:603–610.
GlassFLCottamJAReintgenDSFenskeNA. Lymphatic mapping and sentinel node biopsy in the management of high-risk melanoma. J Am Acad Dermatol1998;39:603–610.
)| false
KangJCWanekLAEssnerR. Sentinel lymphadenectomy does not increase the incidence of in-transit metastases in primary melanoma. J Clin Oncol2005;23:4764–4770.
KangJCWanekLAEssnerR. Sentinel lymphadenectomy does not increase the incidence of in-transit metastases in primary melanoma. J Clin Oncol2005;23:4764–4770.
)| false
MortonDLThompsonJFEssnerR. Validation of the accuracy of intraoperative lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: a multicenter trial. Multicenter Selective Lymphadenectomy Trial Group. Ann Surg1999;230:453–463; discussion 463–465.
MortonDLThompsonJFEssnerR. Validation of the accuracy of intraoperative lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: a multicenter trial. Multicenter Selective Lymphadenectomy Trial Group. Ann Surg1999;230:453–463; discussion 463–465.
)| false
FontaineDParkhillWGreerWWalshN. Partial regression of primary cutaneous melanoma: is there an association with subclinical sentinel lymph node metastasis?Am J Dermatopathol2003;25:371–376.
FontaineDParkhillWGreerWWalshN. Partial regression of primary cutaneous melanoma: is there an association with subclinical sentinel lymph node metastasis?Am J Dermatopathol2003;25:371–376.
)| false
MorrisKTBusamKJBeroS. Primary cutaneous melanoma with regression does not require a lower threshold for sentinel lymph node biopsy. Ann Surg Oncol2008;15:316–322.
MorrisKTBusamKJBeroS. Primary cutaneous melanoma with regression does not require a lower threshold for sentinel lymph node biopsy. Ann Surg Oncol2008;15:316–322.
)| false
CascinelliNBombardieriEBufalinoR. Sentinel and nonsentinel node status in stage IB and II melanoma patients: two-step prognostic indicators of survival. J Clin Oncol2006;24:4464–4471.
CascinelliNBombardieriEBufalinoR. Sentinel and nonsentinel node status in stage IB and II melanoma patients: two-step prognostic indicators of survival. J Clin Oncol2006;24:4464–4471.
)| false
CascinelliNBelliFMacKieRM. Effect of long-term adjuvant therapy with interferon alpha-2a in patients with regional node metastases from cutaneous melanoma: a randomised trial. Lancet2001;358:866–869.
CascinelliNBelliFMacKieRM. Effect of long-term adjuvant therapy with interferon alpha-2a in patients with regional node metastases from cutaneous melanoma: a randomised trial. Lancet2001;358:866–869.
)| false
GrobJJDrenoBde la SalmoniereP. Randomised trial of interferon alpha-2a as adjuvant therapy in resected primary melanoma thicker than 1.5 mm without clinically detectable node metastases. French Cooperative Group on Melanoma. Lancet1998;351:1905–1910.
GrobJJDrenoBde la SalmoniereP. Randomised trial of interferon alpha-2a as adjuvant therapy in resected primary melanoma thicker than 1.5 mm without clinically detectable node metastases. French Cooperative Group on Melanoma. Lancet1998;351:1905–1910.
)| false
HancockBWWheatleyKHarrisS. Adjuvant interferon in high-risk melanoma: the AIM HIGH Study--United Kingdom Coordinating Committee on Cancer Research randomized study of adjuvant low-dose extended-duration interferon alfa-2a in high-risk resected malignant melanoma. J Clin Oncol2004;22:53–61.
HancockBWWheatleyKHarrisS. Adjuvant interferon in high-risk melanoma: the AIM HIGH Study--United Kingdom Coordinating Committee on Cancer Research randomized study of adjuvant low-dose extended-duration interferon alfa-2a in high-risk resected malignant melanoma. J Clin Oncol2004;22:53–61.
)| false
EggermontAMSuciuSMacKieR. Post-surgery adjuvant therapy with intermediate doses of interferon alfa 2b versus observation in patients with stage IIb/III melanoma (EORTC 18952): randomised controlled trial. Lancet2005;366:1189–1196.
EggermontAMSuciuSMacKieR. Post-surgery adjuvant therapy with intermediate doses of interferon alfa 2b versus observation in patients with stage IIb/III melanoma (EORTC 18952): randomised controlled trial. Lancet2005;366:1189–1196.
)| false
KirkwoodJMIbrahimJGSondakVK. High- and low-dose interferon alfa-2b in high-risk melanoma: first analysis of intergroup trial E1690/S9111/C9190. J Clin Oncol2000;18:2444–2458.
KirkwoodJMIbrahimJGSondakVK. High- and low-dose interferon alfa-2b in high-risk melanoma: first analysis of intergroup trial E1690/S9111/C9190. J Clin Oncol2000;18:2444–2458.
)| false
KirkwoodJMIbrahimJGSosmanJA. High-dose interferon alfa-2b significantly prolongs relapse-free and overall survival compared with the GM2-KLH/QS-21 vaccine in patients with resected stage IIB-III melanoma: results of intergroup trial E1694/S9512/C509801. J Clin Oncol2001;19:2370–2380.
KirkwoodJMIbrahimJGSosmanJA. High-dose interferon alfa-2b significantly prolongs relapse-free and overall survival compared with the GM2-KLH/QS-21 vaccine in patients with resected stage IIB-III melanoma: results of intergroup trial E1694/S9512/C509801. J Clin Oncol2001;19:2370–2380.
)| false
KirkwoodJMManolaJIbrahimJ. A pooled analysis of Eastern Cooperative Oncology Group and intergroup trials of adjuvant high-dose interferon for melanoma. Clin Cancer Res2004;10:1670–1677.
KirkwoodJMManolaJIbrahimJ. A pooled analysis of Eastern Cooperative Oncology Group and intergroup trials of adjuvant high-dose interferon for melanoma. Clin Cancer Res2004;10:1670–1677.
)| false
VermaSQuirtIMcCreadyD. Systematic review of systemic adjuvant therapy for patients at high risk for recurrent melanoma. Cancer2006;106:1431–1442.
VermaSQuirtIMcCreadyD. Systematic review of systemic adjuvant therapy for patients at high risk for recurrent melanoma. Cancer2006;106:1431–1442.
)| false
HauschildAGogasHTarhiniA. Practical guidelines for the management of interferon-alpha-2b side effects in patients receiving adjuvant treatment for melanoma: expert opinion. Cancer2008;112:982–994.
HauschildAGogasHTarhiniA. Practical guidelines for the management of interferon-alpha-2b side effects in patients receiving adjuvant treatment for melanoma: expert opinion. Cancer2008;112:982–994.
)| false
BonnenMDBalloMTMyersJN. Elective radiotherapy provides regional control for patients with cutaneous melanoma of the head and neck. Cancer2004;100:383–389.
BonnenMDBalloMTMyersJN. Elective radiotherapy provides regional control for patients with cutaneous melanoma of the head and neck. Cancer2004;100:383–389.
)| false
StromEARossMI. Adjuvant radiation therapy after axillary lymphadenectomy for metastatic melanoma: toxicity and local control. Ann Surg Oncol1995;2:445–449.
StromEARossMI. Adjuvant radiation therapy after axillary lymphadenectomy for metastatic melanoma: toxicity and local control. Ann Surg Oncol1995;2:445–449.
)| false
MiddletonMRGrobJJAaronsonN. Randomized phase III study of temozolomide versus dacarbazine in the treatment of patients with advanced metastatic malignant melanoma. J Clin Oncol2000;18:158–166.
MiddletonMRGrobJJAaronsonN. Randomized phase III study of temozolomide versus dacarbazine in the treatment of patients with advanced metastatic malignant melanoma. J Clin Oncol2000;18:158–166.
)| false
LeghaSSRingSPapadopoulosN. A prospective evaluation of a triple-drug regimen containing cisplatin, vinblastine, and dacarbazine (CVD) for metastatic melanoma. Cancer1989;64:2024–2029.
LeghaSSRingSPapadopoulosN. A prospective evaluation of a triple-drug regimen containing cisplatin, vinblastine, and dacarbazine (CVD) for metastatic melanoma. Cancer1989;64:2024–2029.
)| false
McClayEFMastrangeloMJBelletREBerdD. Combination chemotherapy and hormonal therapy in the treatment of malignant melanoma. Cancer Treat Rep1987;71:465–469.
McClayEFMastrangeloMJBelletREBerdD. Combination chemotherapy and hormonal therapy in the treatment of malignant melanoma. Cancer Treat Rep1987;71:465–469.
)| false
ChapmanPBEinhornLHMeyersML. Phase III multicenter randomized trial of the Dartmouth regimen versus dacarbazine in patients with metastatic melanoma. J Clin Oncol1999;17:2745–2751.
ChapmanPBEinhornLHMeyersML. Phase III multicenter randomized trial of the Dartmouth regimen versus dacarbazine in patients with metastatic melanoma. J Clin Oncol1999;17:2745–2751.
)| false
AgarwalaSSKeilholzUHoggD. Randomized phase III study of paclitaxel plus carboplatin with or without sorafenib as second-line treatment in patients with advanced melanoma [abstract]. J Clin Oncol2007;25(Supp 1):Abstract 8510.
AgarwalaSSKeilholzUHoggD. Randomized phase III study of paclitaxel plus carboplatin with or without sorafenib as second-line treatment in patients with advanced melanoma [abstract]. J Clin Oncol2007;25(Supp 1):Abstract 8510.
)| false
RaoRDHoltanSGIngleJN. Combination of paclitaxel and carboplatin as second-line therapy for patients with metastatic melanoma. Cancer2006;106:375–382.
RaoRDHoltanSGIngleJN. Combination of paclitaxel and carboplatin as second-line therapy for patients with metastatic melanoma. Cancer2006;106:375–382.
)| false
AtkinsMBLotzeMTDutcherJP. High-dose recombinant interleukin 2 therapy for patients with metastatic melanoma: analysis of 270 patients treated between 1985 and 1993. J Clin Oncol1999;17:2105–2116.
AtkinsMBLotzeMTDutcherJP. High-dose recombinant interleukin 2 therapy for patients with metastatic melanoma: analysis of 270 patients treated between 1985 and 1993. J Clin Oncol1999;17:2105–2116.
)| false
SmithFODowneySGKlapperJA. Treatment of metastatic melanoma using interleukin-2 alone or in conjunction with vaccines. Clin Cancer Res2008;14:5610–5618.
SmithFODowneySGKlapperJA. Treatment of metastatic melanoma using interleukin-2 alone or in conjunction with vaccines. Clin Cancer Res2008;14:5610–5618.
)| false
LeghaSSRingSBedikianA. Treatment of metastatic melanoma with combined chemotherapy containing cisplatin, vinblastine and dacarbazine (CVD) and biotherapy using interleukin-2 and interferon-alpha. Ann Oncol1996;7:827–835.
LeghaSSRingSBedikianA. Treatment of metastatic melanoma with combined chemotherapy containing cisplatin, vinblastine and dacarbazine (CVD) and biotherapy using interleukin-2 and interferon-alpha. Ann Oncol1996;7:827–835.
)| false
LeghaSSRingSEtonO. Development of a biochemotherapy regimen with concurrent administration of cisplatin, vinblastine, dacarbazine, interferon alfa, and interleukin-2 for patients with metastatic melanoma. J Clin Oncol1998;16:1752–1759.
LeghaSSRingSEtonO. Development of a biochemotherapy regimen with concurrent administration of cisplatin, vinblastine, dacarbazine, interferon alfa, and interleukin-2 for patients with metastatic melanoma. J Clin Oncol1998;16:1752–1759.
)| false
EtonOLeghaSSBedikianAY. Sequential biochemotherapy versus chemotherapy for metastatic melanoma: results from a phase III randomized trial. J Clin Oncol2002;20:2045–2052.
EtonOLeghaSSBedikianAY. Sequential biochemotherapy versus chemotherapy for metastatic melanoma: results from a phase III randomized trial. J Clin Oncol2002;20:2045–2052.
)| false
AtkinsMBHsuJLeeS. Phase III trial comparing concurrent biochemotherapy with cisplatin, vinblastine, dacarbazine, interleukin-2, and interferon alfa-2b with cisplatin, vinblastine, and dacarbazine alone in patients with metastatic, malignant melanoma (E3695): a trial coordinated by the Eastern Cooperative Oncology Group. J Clin Oncol2008;26:5748–5754.
AtkinsMBHsuJLeeS. Phase III trial comparing concurrent biochemotherapy with cisplatin, vinblastine, dacarbazine, interleukin-2, and interferon alfa-2b with cisplatin, vinblastine, and dacarbazine alone in patients with metastatic, malignant melanoma (E3695): a trial coordinated by the Eastern Cooperative Oncology Group. J Clin Oncol2008;26:5748–5754.
)| false
BajettaEDel VecchioMNovaP. Multicenter phase III randomized trial of polychemotherapy (CVD regimen) versus the same chemotherapy (CT) plus subcutaneous interleukin-2 and interferon-alpha2b in metastatic melanoma. Ann Oncol2006;17:571–577.
BajettaEDel VecchioMNovaP. Multicenter phase III randomized trial of polychemotherapy (CVD regimen) versus the same chemotherapy (CT) plus subcutaneous interleukin-2 and interferon-alpha2b in metastatic melanoma. Ann Oncol2006;17:571–577.
)| false
KeilholzUPuntCJGoreM. Dacarbazine, cisplatin, and interferon-alfa-2b with or without interleukin-2 in metastatic melanoma: a randomized phase III trial (18951) of the European Organisation for Research and Treatment of Cancer Melanoma Group. J Clin Oncol2005;23:6747–6755.
KeilholzUPuntCJGoreM. Dacarbazine, cisplatin, and interferon-alfa-2b with or without interleukin-2 in metastatic melanoma: a randomized phase III trial (18951) of the European Organisation for Research and Treatment of Cancer Melanoma Group. J Clin Oncol2005;23:6747–6755.
)| false
RidolfiRChiarion-SileniVGuidaM. Cisplatin, dacarbazine with or without subcutaneous interleukin-2, and interferon alpha-2b in advanced melanoma outpatients: results from an Italian multicenter phase III randomized clinical trial. J Clin Oncol2002;20:1600–1607.
RidolfiRChiarion-SileniVGuidaM. Cisplatin, dacarbazine with or without subcutaneous interleukin-2, and interferon alpha-2b in advanced melanoma outpatients: results from an Italian multicenter phase III randomized clinical trial. J Clin Oncol2002;20:1600–1607.
)| false
IvesNJStoweRLLoriganPWheatleyK. Chemotherapy compared with biochemotherapy for the treatment of metastatic melanoma: a meta-analysis of 18 trials involving 2,621 patients. J Clin Oncol2007;25:5426–5434.
IvesNJStoweRLLoriganPWheatleyK. Chemotherapy compared with biochemotherapy for the treatment of metastatic melanoma: a meta-analysis of 18 trials involving 2,621 patients. J Clin Oncol2007;25:5426–5434.
)| false
TanJKHoVC. Pooled analysis of the efficacy of bacille Calmette-Guerin (BCG) immunotherapy in malignant melanoma. J Dermatol Surg Oncol1993;19:985–990.
TanJKHoVC. Pooled analysis of the efficacy of bacille Calmette-Guerin (BCG) immunotherapy in malignant melanoma. J Dermatol Surg Oncol1993;19:985–990.
)| false
LensMBDawesM. Isolated limb perfusion with melphalan in the treatment of malignant melanoma of the extremities: a systematic review of randomised controlled trials. Lancet Oncol2003;4:359–364.
LensMBDawesM. Isolated limb perfusion with melphalan in the treatment of malignant melanoma of the extremities: a systematic review of randomised controlled trials. Lancet Oncol2003;4:359–364.
)| false
LindnerPDoubrovskyAKamPCThompsonJF. Prognostic factors after isolated limb infusion with cytotoxic agents for melanoma. Ann Surg Oncol2002;9:127–136.
LindnerPDoubrovskyAKamPCThompsonJF. Prognostic factors after isolated limb infusion with cytotoxic agents for melanoma. Ann Surg Oncol2002;9:127–136.
)| false
FawzyFIFawzyNWHyunCS. Malignant melanoma. Effects of an early structured psychiatric intervention, coping, and affective state on recurrence and survival 6 years later. Arch Gen Psychiatry1993;50:681–689.
FawzyFIFawzyNWHyunCS. Malignant melanoma. Effects of an early structured psychiatric intervention, coping, and affective state on recurrence and survival 6 years later. Arch Gen Psychiatry1993;50:681–689.
)| false
RhodesAR. Public education and cancer of the skin. What do people need to know about melanoma and nonmelanoma skin cancer?Cancer1995;75:613–636.
RhodesAR. Public education and cancer of the skin. What do people need to know about melanoma and nonmelanoma skin cancer?Cancer1995;75:613–636.
)| false
BasseresNGrobJJRichardMA. Cost-effectiveness of surveillance of stage I melanoma. A retrospective appraisal based on a 10-year experience in a dermatology department in France. Dermatology1995;191:199–203.
BasseresNGrobJJRichardMA. Cost-effectiveness of surveillance of stage I melanoma. A retrospective appraisal based on a 10-year experience in a dermatology department in France. Dermatology1995;191:199–203.
)| false
WeissMLoprinziCLCreaganET. Utility of follow-up tests for detecting recurrent disease in patients with malignant melanomas. JAMA1995;274:1703–1705.
WeissMLoprinziCLCreaganET. Utility of follow-up tests for detecting recurrent disease in patients with malignant melanomas. JAMA1995;274:1703–1705.
)| false