Onkológia 3/2006

ADJUVANT TREATMENT OF MALIGNANT MELANOMA

The most important predictors of relapse (and, therefore, survival) are Breslow´s thickness of the primary melanoma, presence of ulceration and regional lymph node status. Patients with melanomas larger than 4 mm thick have an approximately 50 % risk of relapse, while those with lymph node involvement have a 50 to 85 % risk of metastasis depending on the number of lymph nodes affected and other factors. Thus, a group of patients can be defined who are appropriate candidates for postsurgical adjuvant therapy (highrisk patients). In recent years interferon α2b has been widely evaluated in series of both, nonrandomized and randomized trials in melanoma patients. Data from the completed randomized clinical trials consistently demonstrate that highdose interferon α2b is the most effective adjuvant modality in the management of highrisk melanoma and is associated with an approximate 10 % improvement in relapsefree survival. Lowdose (LD) and intermediate dose (ID) interferon α do not prolong survival of highrisk melanoma patients. Observation is still a reasonable approach in highrisk melanoma patients, who do not accept the risks and toxicities of highdose interferon α2b regimen.

Keywords: high-risk melanoma, adjuvant treatment, highdose interferon α2b, relapse, survival.