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Melanoma: HELP
Articles by Jeffrey E. Gershenwald
Based on 150 articles published since 2009
(Why 150 articles?)
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Between 2009 and 2019, J. Gershenwald wrote the following 150 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6
1 Guideline Guidelines of care for the management of primary cutaneous melanoma. 2019

Swetter, Susan M / Tsao, Hensin / Bichakjian, Christopher K / Curiel-Lewandrowski, Clara / Elder, David E / Gershenwald, Jeffrey E / Guild, Valerie / Grant-Kels, Jane M / Halpern, Allan C / Johnson, Timothy M / Sober, Arthur J / Thompson, John A / Wisco, Oliver J / Wyatt, Samantha / Hu, Shasa / Lamina, Toyin. ·Department of Dermatology, Stanford University Medical Center and Cancer Institute, Stanford, California; Veterans Affairs Palo Alto Health Care System, Palo Alto, California. Electronic address: sswetter@stanford.edu. · Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Wellman Center for Photomedicine, Boston, Massachusetts. · Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan; Comprehensive Cancer Center, Ann Arbor, Michigan. · Division of Dermatology, University of Arizona, Tucson, Arizona; University of Arizona Cancer Center, Tucson, Arizona. · Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. · Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas; Department of Cancer Biology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas. · AIM at Melanoma Foundation, Plano, Texas. · Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut; Department of Pathology, University of Connecticut Health Center, Farmington, Connecticut; Department of Pediatrics, University of Connecticut Health Center, Farmington, Connecticut. · Department of Dermatology, Memorial Sloan-Kettering Cancer Center, New York, New York. · Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. · Division of Oncology, University of Washington, Seattle, Washington; Seattle Cancer Care Alliance, Seattle, Washington. · Department of Dermatology, Oregon Health and Science University, Portland, Oregon. · Decatur Dermatology, Decatur, Alabama. · Department of Dermatology, University of Miami Health System, Miami, Florida. · American Academy of Dermatology, Rosemont, Illinois. ·J Am Acad Dermatol · Pubmed #30392755.

ABSTRACT: The incidence of primary cutaneous melanoma continues to increase each year. Melanoma accounts for the majority of skin cancer-related deaths, but treatment is usually curative following early detection of disease. In this American Academy of Dermatology clinical practice guideline, updated treatment recommendations are provided for patients with primary cutaneous melanoma (American Joint Committee on Cancer stages 0-IIC and pathologic stage III by virtue of a positive sentinel lymph node biopsy). Biopsy techniques for a lesion that is clinically suggestive of melanoma are reviewed, as are recommendations for the histopathologic interpretation of cutaneous melanoma. The use of laboratory, molecular, and imaging tests is examined in the initial work-up of patients with newly diagnosed melanoma and for follow-up of asymptomatic patients. With regard to treatment of primary cutaneous melanoma, recommendations for surgical margins and the concepts of staged excision (including Mohs micrographic surgery) and nonsurgical treatments for melanoma in situ, lentigo maligna type (including topical imiquimod and radiation therapy), are updated. The role of sentinel lymph node biopsy as a staging technique for cutaneous melanoma is described, with recommendations for its use in clinical practice. Finally, current data regarding pregnancy and melanoma, genetic testing for familial melanoma, and management of dermatologic toxicities related to novel targeted agents and immunotherapies for patients with advanced disease are summarized.

2 Editorial Embracing changes to the American Joint Committee on Cancer 8th edition melanoma staging system. 2019

Haydu, Lauren E / Thompson, John F / Scolyer, Richard A / Gershenwald, Jeffrey E. ·Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. · Melanoma Institute Australia and Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. · Melanoma Institute Australia and Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. Electronic address: Richard.Scolyer@health.nsw.gov.au. ·Eur J Cancer · Pubmed #30884440.

ABSTRACT: -- No abstract --

3 Editorial Completion Node Dissection for Sentinel Node-Positive Melanoma: Can a Systematic Review Bring One Discussion to a Close While Leaving the Broader Conversation Still Open? 2019

Berman, Russell S / Gershenwald, Jeffrey E. ·Department of Surgery, Division of Oncology, New York University School of Medicine, New York, NY, USA. Russell.Berman@nyumc.org. · Division of Surgery, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. ·Ann Surg Oncol · Pubmed #30737667.

ABSTRACT:

4 Editorial Melanoma Staging: American Joint Committee on Cancer (AJCC) 8th Edition and Beyond. 2018

Gershenwald, Jeffrey E / Scolyer, Richard A. ·Departments of Surgical Oncology and Cancer Biology, Unit 1484, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. jgershen@mdanderson.org. · Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. jgershen@mdanderson.org. · Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia. · Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. · Sydney Medical School, The University of Sydney, Sydney, NSW, Australia. ·Ann Surg Oncol · Pubmed #29850954.

ABSTRACT: -- No abstract --

5 Editorial Stemming the Rising Incidence of Melanoma: Calling Prevention to Action. 2016

Gershenwald, Jeffrey E / Guy, Gery P. ·Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. · Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia jgershen@mdanderson.org. ·J Natl Cancer Inst · Pubmed #26563358.

ABSTRACT: -- No abstract --

6 Editorial Teens and indoor tanning: time to act on the US Food and Drug Administration's black-box warning. 2015

Gottlieb, Mark / Balk, Sophie J / Geller, Alan C / Gershenwald, Jeffrey E. ·Public Health Advocacy Institute, Northeastern University School of Law, Boston, MA, USA. ·Ann Surg Oncol · Pubmed #25515195.

ABSTRACT: -- No abstract --

7 Editorial Clinical value of the sentinel-node biopsy in primary cutaneous melanoma. 2014

Balch, Charles M / Gershenwald, Jeffrey E. ·From the University of Texas Southwestern Medical Center, Dallas (C.M.B.) · and the Department of Surgical Oncology, Melanoma and Skin Center, University of Texas M.D. Anderson Cancer Center, Houston (J.E.G.). ·N Engl J Med · Pubmed #24521113.

ABSTRACT: -- No abstract --

8 Editorial The challenge of defining guidelines for sentinel lymph node biopsy in patients with thin primary cutaneous melanomas. 2012

Gershenwald, Jeffrey E / Coit, Daniel G / Sondak, Vernon K / Thompson, John F. · ·Ann Surg Oncol · Pubmed #22868918.

ABSTRACT: -- No abstract --

9 Editorial 2010 TNM staging system for cutaneous melanoma...and beyond. 2010

Gershenwald, Jeffrey E / Soong, Seng-jaw / Balch, Charles M / Anonymous3450655. · ·Ann Surg Oncol · Pubmed #20300965.

ABSTRACT: -- No abstract --

10 Review Melanoma pathology reporting and staging. 2019

Scolyer, Richard A / Rawson, Robert V / Gershenwald, Jeffrey E / Ferguson, Peter M / Prieto, Victor G. ·Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia. richard.scolyer@health.nsw.gov.au. · Sydney Medical School, The University of Sydney, Sydney, NSW, Australia. richard.scolyer@health.nsw.gov.au. · Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital & NSW Health Pathology, Camperdown, NSW, 2050, Australia. richard.scolyer@health.nsw.gov.au. · Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia. · Sydney Medical School, The University of Sydney, Sydney, NSW, Australia. · Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital & NSW Health Pathology, Camperdown, NSW, 2050, Australia. · University of Texas, MD Anderson Cancer Center, Houston, TX, 77030, USA. ·Mod Pathol · Pubmed #31758078.

ABSTRACT: The pathological diagnosis of melanoma can be challenging. The provision of an appropriate biopsy and pertinent history can assist in establishing an accurate diagnosis and reliable estimate of prognosis. In their reports, pathologists should document both the criteria on which the diagnosis was based as well as important prognostic parameters. For melanoma, such prognostic parameters include tumor thickness, ulceration, mitotic rate, lymphovascular invasion, neurotropism, and tumor-infiltrating lymphocytes. Disease staging is important for risk stratifying melanoma patients into prognostic groups and patient management recommendations are often stage based. The 8th edition American Joint Committee on Cancer (AJCC) Melanoma Staging System was implemented in 2018 and several important changes were made. Tumor thickness and ulceration remain the key T category criteria. T1b melanomas were redefined as either ulcerated melanomas <1.0 mm thick or nonulcerated melanomas 0.8-1.0 mm thick. Although mitotic rate was removed as a T category criterion in the 8th edition, it remains a very important prognostic factor and should continue to be documented in primary melanoma pathology reports. It was also recommended in the 8th edition that tumor thickness be recorded to the nearest 0.1 mm (rather than the nearest 0.01 mm). In the future, incorporation of additional prognostic parameters beyond those utilized in the current version of the staging system into (web based) prognostic models/clinical tools will likely facilitate more personalized prognostic estimates. Evaluation of molecular markers of prognosis is an active area of current research; however, additional data are needed before it would be appropriate to recommend use of such tests in routine clinical practice.

11 Review Neoadjuvant systemic therapy in melanoma: recommendations of the International Neoadjuvant Melanoma Consortium. 2019

Amaria, Rodabe N / Menzies, Alexander M / Burton, Elizabeth M / Scolyer, Richard A / Tetzlaff, Michael T / Antdbacka, Robert / Ariyan, Charlotte / Bassett, Roland / Carter, Brett / Daud, Adil / Faries, Mark / Fecher, Leslie A / Flaherty, Keith T / Gershenwald, Jeffrey E / Hamid, Omid / Hong, Angela / Kirkwood, John M / Lo, Serigne / Margolin, Kim / Messina, Jane / Postow, Michael A / Rizos, Helen / Ross, Merrick I / Rozeman, Elisa A / Saw, Robyn P M / Sondak, Vernon / Sullivan, Ryan J / Taube, Janis M / Thompson, John F / van de Wiel, Bart A / Eggermont, Alexander M / Davies, Michael A / Anonymous4371287 / Ascierto, Paolo A / Spillane, Andrew J / van Akkooi, Alexander C J / Wargo, Jennifer A / Blank, Christian U / Tawbi, Hussein A / Long, Georgina V. ·Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA. · Melanoma Institute of Australia, The University of Sydney, Sydney, NSW, Australia; Department of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Department of Medical Oncology, Mater Hospital Sydney, Sydney, NSW, Australia. · Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA. · Melanoma Institute of Australia, The University of Sydney, Sydney, NSW, Australia; Royal Prince Alfred Hospital, Sydney, Australia. · Department of Pathology and Translational and Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA. · Birdie Pharmaceuticals, Iselin, NJ, USA. · Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, NY, USA. · Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA. · Department of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA. · University of California San Francisco, San Francisco, CA, USA. · The Angeles Clinic and Research Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA. · University of Michigan, Ann Arbor, MI, USA. · Massachusetts General Hospital Cancer Center, Boston, MA, USA. · University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, PA, USA. · Melanoma Institute of Australia, The University of Sydney, Sydney, NSW, Australia. · City of Hope, Duarte, CA, USA. · Moffitt Cancer Center, Tampa, FL, USA. · Department of Medicine, Memorial Sloan Kettering Cancer Center, New York City, NY, USA; Department of Medicine, Weill Cornell Medical College, New York City, NY, USA. · Melanoma Institute of Australia, The University of Sydney, Sydney, NSW, Australia; Macquarie University, Sydney, Australia. · Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, Netherlands. · Melanoma Institute of Australia, The University of Sydney, Sydney, NSW, Australia; Department of Melanoma Surgery, Mater Hospital Sydney, Sydney, NSW, Australia; Royal Prince Alfred Hospital, Sydney, Australia. · Johns Hopkins Hospital, Baltimore, MD, USA. · Department of Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, Netherlands. · Experimental Medical Oncology for Melanoma, Cancer Immunotherapy and Development Therapeutics-Istituto Nazionale Tumouri IRCCS Fondazione Pascale, Napoli, Italy. · Melanoma Institute of Australia, The University of Sydney, Sydney, NSW, Australia; Department of Surgical Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Department of Melanoma Surgery, Mater Hospital Sydney, Sydney, NSW, Australia. · Department of Surgical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, Netherlands. · Melanoma Institute of Australia, The University of Sydney, Sydney, NSW, Australia; Department of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Department of Medical Oncology, Mater Hospital Sydney, Sydney, NSW, Australia. Electronic address: georgina.long@sydney.edu.au. ·Lancet Oncol · Pubmed #31267972.

ABSTRACT: Advances in the treatment of metastatic melanoma have improved responses and survival. However, many patients continue to experience resistance or toxicity to treatment, highlighting a crucial need to identify biomarkers and understand mechanisms of response and toxicity. Neoadjuvant therapy for regional metastases might improve operability and clinical outcomes over upfront surgery and adjuvant therapy, and has become an established role for drug development and biomarker discovery in other cancers (including locally advanced breast cancer, head and neck squamous cell carcinomas, gastroesophageal cancer, and anal cancer). Patients with clinically detectable stage III melanoma are ideal candidates for neoadjuvant therapy, because they represent a high-risk patient population with poor outcomes when treated with upfront surgery alone. Neoadjuvant therapy is now an active area of research for melanoma with numerous completed and ongoing trials (since 2014) with disparate designs, endpoints, and analyses under investigation. We have, therefore, established the International Neoadjuvant Melanoma Consortium with experts in medical oncology, surgical oncology, pathology, radiation oncology, radiology, and translational research to develop recommendations for investigating neoadjuvant therapy in melanoma to align future trial designs and correlative analyses. Alignment and consistency of neoadjuvant trials will facilitate optimal data organisation for future regulatory review and strengthen translational research across the melanoma disease continuum.

12 Review Chemoprevention agents for melanoma: A path forward into phase 3 clinical trials. 2019

Jeter, Joanne M / Bowles, Tawnya L / Curiel-Lewandrowski, Clara / Swetter, Susan M / Filipp, Fabian V / Abdel-Malek, Zalfa A / Geskin, Larisa J / Brewer, Jerry D / Arbiser, Jack L / Gershenwald, Jeffrey E / Chu, Emily Y / Kirkwood, John M / Box, Neil F / Funchain, Pauline / Fisher, David E / Kendra, Kari L / Marghoob, Ashfaq A / Chen, Suephy C / Ming, Michael E / Albertini, Mark R / Vetto, John T / Margolin, Kim A / Pagoto, Sherry L / Hay, Jennifer L / Grossman, Douglas / Ellis, Darrel L / Kashani-Sabet, Mohammed / Mangold, Aaron R / Markovic, Svetomir N / Nelson, Kelly C / Powers, Jennifer G / Robinson, June K / Sahni, Debjani / Sekulic, Aleksandar / Sondak, Vernon K / Wei, Maria L / Zager, Jonathan S / Dellavalle, Robert P / Thompson, John A / Weinstock, Martin A / Leachman, Sancy A / Cassidy, Pamela B. ·Department of Medicine, Divisions of Genetics and Oncology, The Ohio State University, Columbus, Ohio. · Department of Surgery, Intermountain Health Care, Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah. · Department of Medicine, The University of Arizona Cancer Center, Tucson, Arizona. · Department of Dermatology, Pigmented Lesion and Melanoma Program, Stanford University Medical Center Cancer Institute, Veterans Affairs Palo Alto Health Care System, Palo Alto, California. · Systems Biology and Cancer Metabolism, Program for Quantitative Systems Biology, University of California Merced, Merced, California. · Department of Dermatology, University of Cincinnati, Cincinnati, Ohio. · Department of Dermatology, Cutaneous Oncology Center, Columbia University Medical Center, New York, New York. · Department of Dermatologic Surgery, Mayo Clinic Minnesota, Rochester, Minnesota. · Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia. · Division of Dermatology, Veterans Affairs Medical Center, Atlanta, Georgia. · Departments of Surgical Oncology and Cancer Biology, Melanoma and Skin Cancer Center, The University of Texas MD Anderson Cancer Center, Houston, Texas. · Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. · Melanoma and Skin Cancer Program, Department of Medicine, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania. · Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado. · Dermatology Service, U.S. Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, Colorado. · Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado. · Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio. · Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts. · Department of Internal Medicine, Medical Oncology Division, The Ohio State University, Columbus, Ohio. · Memorial Sloan Kettering Skin Cancer Center and Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, New York. · Department of Medicine, University of Wisconsin, School of Medicine and Public Health, University of Wisconsin Carbone Cancer Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin. · Division of Surgical Oncology, Oregon Health & Science University, Portland, Oregon. · Department of Medical Oncology, City of Hope National Medical Center, Duarte, California. · Department of Allied Health Sciences, UConn Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, Connecticut. · Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York. · Departments of Dermatology and Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah. · Department of Dermatology, Vanderbilt University Medical Center and Division of Dermatology, Vanderbilt Ingram Cancer Center, Nashville, Tennessee. · Department of Medicine, Tennessee Valley Healthcare System, Nashville Veterans Affairs Medical Center, Nashville, Tennessee. · Center for Melanoma Research and Treatment, California Pacific Medical Center, San Francisco, California. · Department of Dermatology, Mayo Clinic, Scottsdale, Arizona. · Department of Hematology and Oncology, Mayo Clinic, Rochester, Minnesota. · Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas. · Department of Dermatology, University of Iowa, Iowa City, Iowa. · Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois. · Department of Dermatology, Boston Medical Center, Boston, Massachusetts. · Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida. · Departments of Oncologic Sciences and Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida. · Department of Dermatology, University of California, San Francisco, San Francisco, California. · Dermatology Service, San Francisco Veterans Affairs Medical Center, San Francisco, California. · Department of Sarcoma, H. Lee Moffitt Cancer Center, Tampa, Florida. · Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington. · Center for Dermatoepidemiology, Veterans Affairs Medical Center, Providence, Rhode Island. · Department of Dermatology, Brown University, Providence, Rhode Island. · Department of Epidemiology, Brown University, Providence, Rhode Island. · Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island. · Department of Dermatology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon. ·Cancer · Pubmed #30281145.

ABSTRACT: Recent progress in the treatment of advanced melanoma has led to unprecedented improvements in overall survival and, as these new melanoma treatments have been developed and deployed in the clinic, much has been learned about the natural history of the disease. Now is the time to apply that knowledge toward the design and clinical evaluation of new chemoprevention agents. Melanoma chemoprevention has the potential to reduce dramatically both the morbidity and the high costs associated with treating patients who have metastatic disease. In this work, scientific and clinical melanoma experts from the national Melanoma Prevention Working Group, composed of National Cancer Trials Network investigators, discuss research aimed at discovering and developing (or repurposing) drugs and natural products for the prevention of melanoma and propose an updated pipeline for translating the most promising agents into the clinic. The mechanism of action, preclinical data, epidemiological evidence, and results from available clinical trials are discussed for each class of compounds. Selected keratinocyte carcinoma chemoprevention studies also are considered, and a rationale for their inclusion is presented. These data are summarized in a table that lists the type and level of evidence available for each class of agents. Also included in the discussion is an assessment of additional research necessary and the likelihood that a given compound may be a suitable candidate for a phase 3 clinical trial within the next 5 years.

13 Review Lifestyle Modifications and Policy Implications for Primary and Secondary Cancer Prevention: Diet, Exercise, Sun Safety, and Alcohol Reduction. 2018

LoConte, Noelle K / Gershenwald, Jeffrey E / Thomson, Cynthia A / Crane, Tracy E / Harmon, Gil E / Rechis, Ruth. ·From the Carbone Cancer Center and University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Surgical Oncology, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona Cancer Center, Tucson, AZ; Biobehavioral Health Sciences Division, College of Nursing, University of Arizona Cancer Center, Tucson, AZ; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI; Be Well Communities, Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX. ·Am Soc Clin Oncol Educ Book · Pubmed #30231343.

ABSTRACT: Improved cancer treatments and cancer detection methods are not likely to completely eradicate the burden of cancer. Primary prevention of cancer is a logical strategy to use to control cancer while also seeking novel treatments and earlier detection. Lifestyle modification strategies to improve primary prevention and risk reduction for the development of cancer include choosing a healthy diet with an emphasis on plant sources, maintaining a healthy weight throughout life, being physically active, regularly using sunscreen and wearing protective clothing, limiting sun exposure during the hours of 10 AM to 2 PM, avoiding indoor tanning, and reducing or eliminating alcohol use. In addition to continued use of ongoing education of the public, health care providers, and cancer support communities, other policy and public health efforts should be pursued as well. Examples of supported and successful policy approaches are included in this article, including efforts to limit indoor tanning and improve community-wide interventions to reduce ultraviolet radiation exposure as well as to formally support various alcohol policy strategies including increasing alcohol taxes, reducing alcohol outlet density, improving clinical screening for alcohol use disorders, and limiting youth exposure to alcohol marketing and advertising. These prevention strategies are expected to have the largest impact on the development of melanoma as well as breast, colorectal, head and neck, liver, and esophageal cancers. The impact of these strategies as secondary prevention is less well understood. Areas of additional needed research and implementation are also highlighted. Future areas of needed research are the effects of these modifications after the diagnosis of cancer (as secondary prevention).

14 Review The eighth edition American Joint Committee on Cancer (AJCC) melanoma staging system: implications for melanoma treatment and care. 2018

Keung, Emily Z / Gershenwald, Jeffrey E. ·a Department of Surgical Oncology , The University of Texas MD Anderson Cancer Center , Houston , TX , USA. · b Melanoma and Skin Center , The University of Texas MD Anderson Cancer Center , Houston , TX , USA. ·Expert Rev Anticancer Ther · Pubmed #29923435.

ABSTRACT: INTRODUCTION: The eighth edition of the American Joint Committee on Cancer (AJCC) melanoma staging system was implemented in the United States on 1 January 2018. Areas covered: This article provides an overview of important changes in the eighth edition AJCC staging system from the seventh edition based on analyses of a large international melanoma database. The clinical implications of these changes for melanoma treatment are also discussed. Expert commentary: A standardized and contemporary cancer staging system that facilitates accurate risk stratification is essential to guide patient treatment. The eighth edition of the AJCC staging system is currently the most widely accepted approach to melanoma staging and classification at initial diagnosis.

15 Review State of the science on prevention and screening to reduce melanoma incidence and mortality: The time is now. 2016

Tripp, Mary K / Watson, Meg / Balk, Sophie J / Swetter, Susan M / Gershenwald, Jeffrey E. ·Instructor, Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX. · Epidemiologist, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. · Attending Pediatrician, Children's Hospital at Montefiore, and Professor of Clinical Pediatrics, Albert Einstein College of Medicine, Bronx, NY. · Professor, Department of Dermatology, and Director, Pigmented Lesion and Melanoma Program, Stanford University Medical Center and Cancer Institute, Stanford, CA. · Professor and Assistant Chief, Dermatology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA. · Dr. John M. Skibber Professor, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX. · Professor, Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX. · Medical Director, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX. · Co-Leader, Melanoma Moon Shot, The University of Texas MD Anderson Cancer Center, Houston, TX. ·CA Cancer J Clin · Pubmed #27232110.

ABSTRACT: Answer questions and earn CME/CNE Although overall cancer incidence rates are decreasing, melanoma incidence rates continue to increase about 3% annually. Melanoma is a significant public health problem that exacts a substantial financial burden. Years of potential life lost from melanoma deaths contribute to the social, economic, and human toll of this disease. However, most cases are potentially preventable. Research has clearly established that exposure to ultraviolet radiation increases melanoma risk. Unprecedented antitumor activity and evolving survival benefit from novel targeted therapies and immunotherapies are now available for patients with unresectable and/or metastatic melanoma. Still, prevention (minimizing sun exposure that may result in tanned or sunburned skin and avoiding indoor tanning) and early detection (identifying lesions before they become invasive or at an earlier stage) have significant potential to reduce melanoma incidence and melanoma-associated deaths. This article reviews the state of the science on prevention and early detection of melanoma and current areas of scientific uncertainty and ongoing debate. The US Surgeon General's Call to Action to Prevent Skin Cancer and US Preventive Services Task Force reviews on skin cancer have propelled a national discussion on melanoma prevention and screening that makes this an extraordinary and exciting time for diverse disciplines in multiple sectors-health care, government, education, business, advocacy, and community-to coordinate efforts and leverage existing knowledge to make major strides in reducing the public health burden of melanoma in the United States. CA Cancer J Clin 2016;66:460-480. © 2016 American Cancer Society.

16 Review Critical Assessment of Clinical Prognostic Tools in Melanoma. 2016

Mahar, Alyson L / Compton, Carolyn / Halabi, Susan / Hess, Kenneth R / Gershenwald, Jeffrey E / Scolyer, Richard A / Groome, Patti A. ·Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON, Canada. · Arizona State University, Phoenix, AZ, USA. · School of Medicine, Mayo Clinic, Rochester, MN, USA. · Department of Biostatistics and Bioinformatics, Alliance Statistics and Data Center, Duke University, Durham, NC, USA. · Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. · Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. · Melanoma Institute Australia, Sydney, NSW, Australia. · Sydney Medical School, The University of Sydney, Sydney, NSW, Australia. · Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, NSW, Australia. · Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON, Canada. groomep@queensu.ca. ·Ann Surg Oncol · Pubmed #27052645.

ABSTRACT: The 7th edition American Joint Committee on Cancer (AJCC) melanoma staging system classifies patients according to prognosis. Significant within-stage heterogeneity remains and the inclusion of additional clinicopathologic and other host- and tumor-based prognostic factors have been proposed. Clinical prognostic tools have been developed for use in clinical practice to refine survival estimates. Little is known about the comparative features of tools in melanoma. We performed a systematic search of the scientific published literature for clinical prognostic tools in melanoma and web-based resources. A priori criteria were used to evaluate their quality and clinical relevance, and included intended clinical use, model development approaches, validation strategies, and performance metrics. We identified 17 clinical prognostic tools for primary cutaneous melanoma. Patients with stages I-III and T1 or thin melanoma were the most frequently considered populations. Seventy-five percent of tools were developed using data collected from patients diagnosed in 2006 or earlier, and the well-established factors of tumor thickness, ulceration, and age were included in 70 % of tools. Internal validity using cross-validation or bootstrapping techniques was performed for two tools only. Fewer than half were evaluated for external validity; however, when done, the appropriate statistical methodology was applied and results indicated good generalizability. Several clinical prognostic tools have the potential to refine survival estimates for individual melanoma patients; however, there is a great opportunity to improve these tools and to foster the development of new, validated tools by the inclusion of contemporary clinicopathological covariates and by using improved statistical and methodological approaches.

17 Review Principles of Melanoma Staging. 2016

Boland, Genevieve M / Gershenwald, Jeffrey E. ·Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. gmboland@mdanderson.org. · Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. jgershen@mdanderson.org. ·Cancer Treat Res · Pubmed #26601861.

ABSTRACT: Although now commonplace in contemporary cancer care, the systematic approach to classification of disease-specific cancers into a formalized staging system is a relatively modern concept. Overall, the goals of cancer staging are to characterize the status of cancer at a specific moment in time, risk stratify, facilitate prognostication, and inform clinical decision making. The revisions to the American Joint Committee on Cancer (AJCC) melanoma staging system over time reflect changes in our understanding of the biology of the disease. Since the 1st edition, where tumor thickness was defined anatomically by its relationship to the reticular or papillary dermis (Clark level) as well as tumor thickness (Breslow thickness), there have been significant strides in our use of clinicopathological variables to stratify low- versus high-risk patients. Management of the regional nodal basin has also changed dramatically over time, impacted by techniques such as lymphatic mapping and sentinel lymph node biopsy (SLNB) and changes in pathological evaluation of the regional lymph nodes. Additionally, stratification of distant metastases has evolved as survival outcomes have been shown to vary based upon anatomic site of metastases and serum lactate dehydrogenase levels. The variables in use in the current (7th edition) AJCC staging system are surrogate markers of biology with validated impact of survival outcomes. Going forward, it is likely that these and additional clinicopathological factors will be integrated with molecular and other correlates of melanoma tumor biology to further refine and personalize melanoma staging.

18 Review Melanoma. 2015

Schadendorf, Dirk / Fisher, David E / Garbe, Claus / Gershenwald, Jeffrey E / Grob, Jean-Jacques / Halpern, Allan / Herlyn, Meenhard / Marchetti, Michael A / McArthur, Grant / Ribas, Antoni / Roesch, Alexander / Hauschild, Axel. ·Department of Dermatology, University Duisburg-Essen, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, Germany. · German Cancer Consortium (DKTK), Heidelberg, Germany. · Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. · Department of Dermatology, University Tübingen, Tübingen, Germany. · Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. · Department of Dermatology and Skin Cancers, APHM Timone Hospital Aix-Marseille University, Marseille, France. · Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA. · Melanoma Research Center, Wistar Institute, Philadelphia, Pennsylvania, USA. · Division of Cancer Medicine and Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. · Departments of Medicine, Surgery, and Medical and Molecular Pharmacology, University of California Los Angeles, Los Angeles, California, USA. · Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Kiel, Germany. ·Nat Rev Dis Primers · Pubmed #27188223.

ABSTRACT: Melanoma is a common cancer in the Western world with an increasing incidence. Sun exposure is still considered to be the major risk factor for melanoma. The prognosis of patients with malignant (advanced-stage) melanoma differs widely between countries, but public campaigns advocating early detection have led to significant reductions in mortality rates. As well as sun exposure, distinct genetic alterations have been identified as associated with melanoma. For example, families with melanoma who have germline mutations in CDKN2A are well known, whereas the vast majority of sporadic melanomas have mutations in the mitogen-activated protein kinase cascade, which is the pathway with the highest oncogenic and therapeutic relevance for this disease. BRAF and NRAS mutations are typically found in cutaneous melanomas, whereas KIT mutations are predominantly observed in mucosal and acral melanomas. GNAQ and GNA11 mutations prevail in uveal melanomas. Additionally, the PI3K-AKT-PTEN pathway and the immune checkpoint pathways are important. The finding that programmed cell death protein 1 ligand 1 (PDL1) and PDL2 are expressed by melanoma cells, T cells, B cells and natural killer cells led to the recent development of programmed cell death protein 1 (PD1)-specific antibodies (for example, nivolumab and pembrolizumab). Alongside other new drugs - namely, BRAF inhibitors (vemurafenib and dabrafenib) and MEK inhibitors (trametinib and cobimetinib) - these agents are very promising and have been shown to significantly improve prognosis for patients with advanced-stage metastatic disease. Early signs are apparent that these new treatment modalities are also improving long-term clinical benefit and the quality of life of patients. This Primer summarizes the current understanding of melanoma, from mechanistic insights to clinical progress. For an illustrated summary of this Primer, visit: http://go.nature.com/vX2N9s.

19 Review Biology of advanced uveal melanoma and next steps for clinical therapeutics. 2015

Luke, Jason J / Triozzi, Pierre L / McKenna, Kyle C / Van Meir, Erwin G / Gershenwald, Jeffrey E / Bastian, Boris C / Gutkind, J Silvio / Bowcock, Anne M / Streicher, Howard Z / Patel, Poulam M / Sato, Takami / Sossman, Jeffery A / Sznol, Mario / Welch, Jack / Thurin, Magdalena / Selig, Sara / Flaherty, Keith T / Carvajal, Richard D. ·Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA. ·Pigment Cell Melanoma Res · Pubmed #25113308.

ABSTRACT: Uveal melanoma is the most common intraocular malignancy although it is a rare subset of all melanomas. Uveal melanoma has distinct biology relative to cutaneous melanoma, with widely divergent patient outcomes. Patients diagnosed with a primary uveal melanoma can be stratified for risk of metastasis by cytogenetics or gene expression profiling, with approximately half of patients developing metastatic disease, predominately hepatic in location, over a 15-yr period. Historically, no systemic therapy has been associated with a clear clinical benefit for patients with advanced disease, and median survival remains poor. Here, as a joint effort between the Melanoma Research Foundation's ocular melanoma initiative, CURE OM and the National Cancer Institute, the current understanding of the molecular and immunobiology of uveal melanoma is reviewed, and on-going laboratory research into the disease is highlighted. Finally, recent investigations relevant to clinical management via targeted and immunotherapies are reviewed, and next steps in the development of clinical therapeutics are discussed.

20 Review Evidence-based clinical practice guidelines on the use of sentinel lymph node biopsy in melanoma. 2013

Sondak, Vernon K / Wong, Sandra L / Gershenwald, Jeffrey E / Thompson, John F. ·From the Department of Cutaneous Oncology, Moffitt Cancer Center, and Departments of Oncologic Sciences and Surgery, University of South Florida, Tampa, FL; Department of Surgery, University of Michigan Medical Center, Ann Arbor, MI; Departments of Surgical Oncology and Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX; Melanoma Institute Australia and the University of Sydney, Sydney, Australia. ·Am Soc Clin Oncol Educ Book · Pubmed #23714536.

ABSTRACT: Sentinel lymph node biopsy (SLNB) was introduced in 1992 to allow histopathologic evaluation of the "sentinel" node, that is, the first node along the lymphatic drainage pathway from the primary melanoma. This procedure has less risk of complications than a complete lymphadenectomy, and if the sentinel node is uninvolved by tumor the likelihood a complete lymphadenectomy would find metastatic disease in that nodal basin is very low. SLNB is now widely used worldwide in the staging of melanoma as well as breast and Merkel cell carcinomas. SLNB provides safe, reliable staging for patients with clinically node-negative melanomas 1 mm or greater in thickness, with an acceptably low rate of failure in the sentinel node-negative basin. Evidence-based guidelines jointly produced by ASCO and the Society of Surgical Oncology (SSO) recommend SLNB for patients with intermediate-thickness melanomas and also state that SLNB may be recommended for patients with thick melanomas. Major remaining areas of uncertainty include the indications for SLNB in patients with thin melanomas, pediatric patients, and patients with atypical melanocytic neoplasms; the optimal radiotracers and dyes for lymphatic mapping; and the necessity of complete lymphadenectomy in all sentinel node-positive patients.

21 Review Sentinel lymph node biopsy for melanoma: a critical update for dermatologists after two decades of experience. 2013

Ross, Merrick I / Gershenwald, Jeffrey E. ·Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. mross@mdanderson.org ·Clin Dermatol · Pubmed #23608449.

ABSTRACT: The technique of lymphatic mapping and sentinel node biopsy represents a minimally invasive approach to accurately stage the regional lymph node basin as a component of the initial management of selected patients with stage I and II cutaneous melanomas. In addition to its significant role in accurate regional nodal staging and prognosis, important goals of this procedure include improved regional disease control and possible survival benefit. After 20 years of experience, questions and some controversy persist. This review provides the dermatology community with a critical analysis of major publications that have defined the role of sentinel node biopsy, addresses several contemporary issues, and provides recommendations for appropriate patient referral.

22 Review Variability in melanoma post-treatment surveillance practices by country and physician specialty: a systematic review. 2012

Cromwell, Kate D / Ross, Merrick I / Xing, Yan / Gershenwald, Jeffrey E / Royal, Richard E / Lucci, Anthony / Lee, Jeffrey E / Cormier, Janice N. ·Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030-4009, USA. ·Melanoma Res · Pubmed #22914178.

ABSTRACT: There are no evidence-based guidelines for the surveillance of patients with melanoma following surgical treatment. We carried out a systematic review to identify by country and physician specialty the current stage-specific surveillance practices for patients with melanoma. Three major medical indices, MEDLINE, the Cochrane Library database, and Scopus, were reviewed to identify articles published from January 1970 to October 2011 that included detailed information about the surveillance of patients with melanoma after the initial surgical treatment. Data on surveillance intervals and recommended evaluation were extracted and categorized by country and, when reported, physician specialty. One hundred and four articles from 10 countries and four physician specialties (dermatology, surgical oncology, medical oncology, and general practice) fulfilled the inclusion criteria, including 43 providing specific patient-level data. The articles showed a wide variation with respect to the surveillance intervals and recommended evaluations. The variation was greatest for patients with stage I disease, for whom the follow-up frequency ranged from one to six visits per year during years 1 and 2 after treatment. All four physician specialties agreed that for years 1-3, the follow-up frequency should be four times per year for all patients. For years 4 and 5, surgical oncologists recommended two follow-up visits per year, whereas general practitioners, dermatologists, and medical oncologists recommended four visits per year. Recommended imaging and laboratory evaluations were most intense in the UK and most minimalist in the Netherlands. Although general practitioners did not recommend routine laboratory or imaging tests for surveillance, all other specialties utilized both in their surveillance practice. Self skin-examination was recommended for surveillance in all countries and by all practitioner specialties. There are significant intercountry and interspecialty variations in the surveillance of patients with melanoma. As the number of melanoma survivors increases, it will be critical to examine the benefits and costs of various follow-up strategies to establish consensus guidelines for melanoma post-treatment surveillance.

23 Review Sentinel lymph node biopsy in melanoma. 2012

Boland, Genevieve M / Gershenwald, Jeffrey E. ·Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. ·Cancer J · Pubmed #22453020.

ABSTRACT: The technique of lymphatic mapping and sentinel lymph node (SLN) biopsy for melanoma has emerged during the last 2 decades as a minimally invasive approach to evaluate regional lymph node basins in patients with intermediate- and high-risk primary cutaneous melanoma and has changed our approach to the clinically negative lymph node basin in melanoma during the same period. This review focuses on preoperative assessment and operative strategies, pathologic evaluation of the SLN, issues related to regional lymph node basin control, and current clinical practice guidelines. Predictors of SLN status, the prognostic significance of the SLN, and areas of controversy are also discussed.

24 Review Update on the melanoma staging system: the importance of sentinel node staging and primary tumor mitotic rate. 2011

Balch, Charles M / Gershenwald, Jeffrey E / Soong, Seng-Jaw / Thompson, John F. ·Johns Hopkins Medical Institutions, Baltimore, Maryland, USA. balchch@jhmi.edu ·J Surg Oncol · Pubmed #21858832.

ABSTRACT: The 7(th) Edition of the AJCC Staging Manual includes a detailed summary of melanoma staging and prognosis. The revisions are summarized in this article, along with details on two key aspects of melanoma staging: the incorporation of mitotic rate of the primary melanoma and the key role of the sentinel lymph node biopsy (SLNB) in determining accurate staging for clinically occult nodal metastases. Primary tumor mitotic rate was introduced as a major criterion for melanoma staging and prognosis that replaces the Clark's level of invasion, and is now proven to be an important independent adverse predictor of survival. Analysis of the AJCC melanoma staging database demonstrated a significant inverse correlation between primary tumor mitotic rate (histologically defined as mitoses/mm(2) ) and survival. The use of SLNB reliably identifies melanoma patients with nodal micrometastases, enabling clinicians to identify patients with occult nodal metastases that would otherwise take months or years to become clinically palpable The number of nodal metastases was the most significant independent predictor of survival among all patients with stage III disease, including among patients with nodal micrometastases, and continues to be a primary criterion for defining Stage III melanoma. A clinical scoring system model and multivariate predictive tool under the auspices of the AJCC has led to a first-generation web-based predictive tool (www.melanomaprognosis.org).

25 Review Evidence-based treatment of early-stage melanoma. 2011

Ross, Merrick I / Gershenwald, Jeffrey E. ·Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. mross@mdanderson.org ·J Surg Oncol · Pubmed #21858828.

ABSTRACT: The vast majority of patients with newly diagnosed melanoma are "early-stage" - ie, clinically localized to the primary cutaneous site. For such patients, surgery represents the mainstay of treatment; current standards of surgical management have evolved based on evidence obtained from randomized trials, large multi-center and single institutional databases, and consensus panels. Treatment strategies include wide excision of the primary site with margins dictated by important biological features such as Breslow tumor thickness, and sentinel node biopsy to surgically evaluate the regional nodal basins at risk. Sentinel node biopsy has become an important component of the initial management of many of these patients for accurate staging of regional lymph nodes, as well as enhanced regional disease control and improved survival in the patients with microscopically involved nodes. Evidence is presented that supports the rational use of these surgical strategies and reconciles some of the controversies that have emerged. The degree to which established national treatment guidelines are followed and the consequences of non-compliance with these guidelines have become the focus of recent clinical investigations; results of these efforts are also discussed.

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