New trends in diagnosis and treatment of malignant melanoma

The incidence of malignant melanoma is increasing worldwide. Patients who have deep primary melanoma or metastatic melanoma continue to have a high relapse and mortality rate. The only possibility to cure a melanoma is to detect the primary tumor in a very early stage of development and immediately remove it. In vivo epiluminescence microscopy as well as 20-M Hz-sonography improved early detection of malignant melanoma. Whole-body positron emission tomography (PET) has been shown to be useful in early detection of melanoma metastatic to regional draining lymph nodes or to organs. However, no tumor marker appropriate to assess the progression of malignant melanoma is currently available. High-dose adjuvant therapy with interferon-alpha prolongs the relapse-free interval and overall survival of high risk resected melanoma patients. Additionally, palliative treatment of metastatic malignant melanoma with combined chemo-/immunotherapies has been shown to improve tumor remission rates and long-term survival. New strategies for immuno-and gene therapy are currently examined in clinical trials. Nevertheless, intensive educational work is still the best prevention of malignant melanoma.