The ten-year recovery prognosis is favorable: 97% to 57% depending on the initial stage of the tumor. it is important to carry out the checks
I am 65 years old and had melanoma in 2016 (specifically: 2mm thick Breslow, non ulcerated, IV Clark), with positive sentinel lymph node. Now, having passed five years, how many chances do I have of not having recidivism again? When can I consider myself cured?
He answers Mario Santinamidirector of the Melanoma and Sarcoma Facility at the National Institute for the Study and Treatment of Cancer in Milan (GO TO THE FORUM)
To answer your questions it is necessary, of course, to start from the severity of the initial disease, expressed by various parameters. Clark’s levels were a way to try to evaluate the infiltration of the tumor in the various layers of the skin (from the most superficial, the level I represented by the epidermis to the V, which reaches the subcutaneous adipose layer), but today they are considered an inaccurate classification because the skin has different thicknesses in various areas of the body and is used instead the histological thickness according to Breslow. This, in fact, is based on the actual thickness of the melanoma by measuring its depth (in millimeters) from the granular layer of the skin to the point of maximum infiltration.
What is the sentinel lymph node used for
The deeper the disease goes, the more the removal may be more complicated the higher the risk that the tumor has affected the adjacent areas. The presence of histological ulcerationwhich is evaluated by the pathologist, then an indication of greater aggression: a worsening factor for the prognosis that makes the stage of melanoma classified at a higher level. Sentinel lymph node biopsy it is instead used to understand up to what stage the neoplasm has evolved, if and how far it has already gone beyond its initial boundaries, in order to be able to establish whether it is useful for the patient to do (after surgical removal of the melanoma) a so-called adjuvant therapy, to eliminate any cancerous cells scattered in the body, but still invisible to various tests. Today there are several effective drugs for this purpose (both target teraphy is immunotherapy) that manage to limit the chances of a relapse which are administered precisely to the people considered most at risk of undergoing a relapse even after an operation that completely eliminated the disease (stage IIIB or IIIC).
Prognosis and periodic checks
Once all these parameters have been taken into consideration, the prognosis of the individual patient can be assessed, also based on the statistics obtained from scientific studies that evaluate the cases of thousands of patients observed over time. We know so that for localized melanomas we have a 10-year recovery prognosis ranging from 97% to 57% depending on the initial stage. In his specific case, being a stage IIIA with 5 years of follow up, the very good cure rate, about 85%. The important for continue taking exams (ultrasound and chest X-ray) and periodic check-ups up to the tenth year which serve, in fact, to promptly detect any signs of relapse and intervene immediately with the medicines that we know today are able to stop the progression of the tumor in many patients also for long years. Equally relevant to continue also to self-inspect the skin (especially if you have many moles) and promptly report to the doctor the presence of any anomalies: Those who have already had skin cancer are more likely than others to develop another one. After 10 years, one can truly consider oneself cured melanoma being very unlikely to recur. A melanoma operated on at an early stage and with negative lymph nodes, on the other hand, can be considered healed already from the fifth year if it has a Breslow thickness of less than one millimeter (while for all the others the observation period ends at 10 years).
June 14, 2022 (change June 14, 2022 | 21:43)
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