| Popis: |
Background Incidence of malignant melanoma (MM) is rising worldwide. This tumour is immunogenic and angiogenic. Vascular endothelial growth factor (VEGF), interferons and matrix metalloproteinases (MMPs) are natural agents with important role both in immunosuppression/stimulation, and angiogenesis. Interestingly, evidence is currently emerging that activation of angiogenesis leads to immunosuppression both at the local and systemic levels. These are very complex and interconnected processes. Mortality of MM is high and depends very much on early detection. Plateau phase on mortality curves we've seen recently in developed countries thanks to early diagnosis, public awareness of skin pigment lesions, emphasis on primary and secondary prevention, and also thanks to new potent drugs. Cornerstone of treatment in MM is surgery, if the tumour is diagnosed early. We can find surgery sufficient and safe only if the tumour hasn't reached angiogenic switch and vertical growing yet. We cannot exclude trend to create metastasis in tumours with Breslow more than 1mm. The same we can say about ulcerated tumours or nodal metastasis. Patients after surgery for MM stage IIB, IIC and III according to AJCC are thought to be high risk. Their risk of recurrence and death is 35-40%. Loco-regional recurrence after... |
