According to Clark there are three different types of melanoma: malignant melanoma which develops from the floor of a precancerous melanosis, the extensive superficial melanoma and nodular malignant melanoma. Therapeutically, surgery occupies the first place. Chemotherapeutically the combination of 3 or 4 different substances has given favorable results. Immunotherapeutically, immunization with BCG and mycobacteria, especially Cornyebacterium parvum, is considered the most reliable and least dangerous procedure. Altogether, a better prognosis for malignant melanoma can be expected in the future if diagnosis is made early and if treated with an optimum combination therapy.

Antineoplastic Agents↗

PubMed1978

Adjuvant chemotherapy in the management of primary malignant melanoma.

In a prospective randomized study, the effect of chemotherapy (either systemic or combined intraarterial and systemic) was studied in 117 patients undergoing a curative resection of Clark's level III, IV or V malignant melanoma. Systemic chemotherapy was started one month after surgery one week courses with an I.V. injection of Vinblastin 6 mg/m2, Thiotepa 6 mg/m2, Rufocromomycine 60 microgram/m2, Methotrexate 15 mg/m2 on day one with procarbazine 30 mg/m2 orally daily were given every other week for three months and later every four weeks. Intraarterial chemotherapy of DTIC 80 mg/kg day for ten days was given 28 days prior to surgery. 65 patients with limb malignant melanoma were treated either by surgery only (27 patients), or by systemic chemotherapy (23 patients) or by preoperative intraarterial chemotherapy and systemic chemotherapy (15 patients): 52 patients with non limb malignant melanoma were treated either by surgery only (28 patients) or by systemic chemotherapy (24 patients). We drew curves of disease free survival following surgery and studied the levelling off of the curves, 24 months after surgery 65% of the patients treated by surgery alone were alive and free of disease whereas 81% of the patients treated by surgery and chemotherapy were alive and free of disease (p less than 0.05) suggesting a possible benefit of adjuvant chemotherapy. Intraarterial preoperative chemotherapy has not proved of additional benefit to date.

Adult↗

PubMed1977