0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

Lymphangiogenesis:  Host and Tumor Factors in Nodal Metastasis

Vernon K. Sondak, MD; Jane L. Messina, MD
Arch Dermatol. 2008;144(4):536-537. doi:10.1001/archderm.144.4.536.
Text Size: A A A
Published online

Extract

Metastasis of melanoma to regional lymph nodes is readily identified by sentinel lymph node (SLN) biopsy. Sentinel lymph node biopsy in patients with melanoma, while clearly not improving survival in patients with negative SLNs,1 offers other noteworthy advantages that justify the minor increase in morbidity over wide excision alone. These include superior staging and prognostication1,2; improved relapse-free survival, with more patients alive and free from relapse at 5 years postoperatively1; improved regional control and potentially less morbidity compared with node dissection performed because of palpable metastases3; and, perhaps, improved survival in patients with positive SLNs.1 Another underappreciated value of SLN biopsy is enhancement of our understanding of the metastatic process. Available prognostic factors, based on clinical parameters and histologic findings in the primary tumor, are limited in their ability to reliably determine which patients will manifest SLN metastasis or disseminated disease, indicating the presence of missing links in our understanding of how melanomas metastasize.4 There is an unmet clinical need for improved predictive biomarkers of metastasis in clinically localized primary melanomas. These new biomarkers can be derived only from improved understanding of melanoma biology and the inherent variations in the host response to the tumor.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();