Genetic factors in metastatic progression of cutaneous melanoma: the future role of circulating melanoma cells in prognosis and management |
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Authors: | A Ireland M Millward R Pearce M Lee M Ziman |
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Institution: | (1) Department of Medicine, University of Western Australia, Crawley, WA, Australia;(2) ECU Melanoma Research Foundation, School of Exercise, Biomedical and Health Science, Edith Cowan University, 270 Joondalup Drive, Perth, WA, 6027, Australia;(3) Department of Pathology and Laboratory Medicine, University of Western Australia, Crawley, WA, Australia;(4) School of Surgery, University of Western Australia, Crawley, WA, Australia; |
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Abstract: | The greatest potential for improvement of outcome for patients with Cutaneous Malignant Melanoma lies in the prevention of
systemic metastasis. Despite extensive investigation, current prognostic indicators either alone or in combination, although
related to melanoma progression, are not sufficient to accurately predict the pattern of progression and outcome for any individual
patient. Metastasis related death has been recorded in patients initially diagnosed with early stage tumour as well as in
patients many years after initial tumour removal. The trouble finding a predictable pattern in the puzzle of melanoma progression
may be linked to the fact that most of the material studied for prognosis is either, cutaneous primaries or metastatic deposits,
rather than the melanoma cells in the circulatory system which are responsible for disease progression. In this review article
we discuss the potential use of circulating tumour cell (CTC) detection and quantification for identifying patients at risk
of metastatic deposits. We also discuss current therapies for the treatment of metastatic melanoma and analyse how CTCs may
be used to evaluate the effectiveness of current therapies and to pinpoint patients who require further treatment. |
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