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Vol. 100. Issue 9.
Pages 759-766 (November 2009)
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Vol. 100. Issue 9.
Pages 759-766 (November 2009)
Controversies in dermatology
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Problems in Defining Melanoma Regression and Prognostic Implication
Regresión en el Melanoma: Problemas en su Definición e Implicación Pronóstica
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C. Requenaa,
Corresponding author
celiareq@hotmail.com

Correspondence: Servicio de Dermatología. Instituto Valenciano de Oncología. C/ Profesor Beltrán Báguena, n.° 8. 46009 Valencia, Spain.
, R. Botella-Estradaa, V. Travesb, E. Nagorea, S. Almenarb, C. Guilléna
a Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain
b Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, Spain
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Abstract

Between 10% and 35% of all melanomas show histological regression. That is, there is an area within the melanoma where the tumor retreats or disappears to be progressively replaced by fibrosis with presence of melanophages and variable degrees of inflammation, and increased vascularity. Such regression is generally considered an indicator of poor prognosis in melanoma, although a number of studies contradict this affirmation.

In this review, we summarize the leading articles about the influence of regression on melanoma prognosis. The results of these studies are very inconsistent, and so the prognostic significance of regression is somewhat controversial. We believe that some of these differences can be explained by differing criteria for regression and so we propose clear histological criteria to define early and sustained regression.

Key words:
melanoma
regression
prognosis
sentinel lymph node
metastasis
Resumen

Entre un 10 y un 35% de todos los melanomas presentan regresión histológica, es decir, un área en el seno del melanoma en el que el tumor disminuye o desaparece y es sustituido progresivamente por fibrosis, con cantidades variables de melanófagos, inflamación y neovascularización. Aunque mayoritariamente se considera la presencia de regresión como un factor de mal pronóstico en el melanoma, existen varios trabajos que contradicen esta idea. En esta revisión resumimos los principales artículos publicados sobre la influencia de la regresión en el pronóstico del melanoma y encontramos resultados muy dispares, de modo que el significado pronóstico de la regresión en el melanoma es, a la vista de los trabajos publicados, cuando menos controvertido. Pensamos que parte de las diferencias encontradas se pueden deber a la disparidad en cuanto a los criterios utilizados para definir la regresión, y por ello proponemos unos criterios histológicos que aclaren los conceptos de regresión temprana y establecida.

Palabras clave:
melanoma
regresión
pronóstico
ganglio centinela
metástasis
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Copyright © 2009. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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