array:23 [
  "pii" => "S1578219010705990"
  "issn" => "15782190"
  "doi" => "10.1016/S1578-2190(10)70599-0"
  "estado" => "S300"
  "fechaPublicacion" => "2010-03-01"
  "aid" => "70599"
  "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L."
  "copyrightAnyo" => "2010"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Actas Dermosifiliogr. 2010;101:129-42"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 3289
    "formatos" => array:3 [
      "EPUB" => 39
      "HTML" => 1705
      "PDF" => 1545
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1578219010706004"
    "issn" => "15782190"
    "doi" => "10.1016/S1578-2190(10)70600-4"
    "estado" => "S300"
    "fechaPublicacion" => "2010-03-01"
    "aid" => "70600"
    "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L."
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Actas Dermosifiliogr. 2010;101:143-50"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1968
      "formatos" => array:3 [
        "EPUB" => 39
        "HTML" => 1171
        "PDF" => 758
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Attitude of the Adult Patient With Atopic Dermatitis to the Disease and Its Treatment&#58; The ACTIDA Study"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "143"
          "paginaFinal" => "150"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Actitud del paciente adulto con dermatitis at&#243;pica frente a su patolog&#237;a y tratamiento&#46; Estudio ACTIDA"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "I&#46; Betlloch, R&#46; Izu, M&#46; Lleonart, M&#46; Ferrer, J&#46; Ferrando"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "I&#46;"
              "apellidos" => "Betlloch"
            ]
            1 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Izu"
            ]
            2 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Lleonart"
            ]
            3 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Ferrer"
            ]
            4 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Ferrando"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219010706004?idApp=UINPBA000044"
    "url" => "/15782190/0000010100000002/v1_201304241515/S1578219010706004/v1_201304241515/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1578219010705989"
    "issn" => "15782190"
    "doi" => "10.1016/S1578-2190(10)70598-9"
    "estado" => "S300"
    "fechaPublicacion" => "2010-03-01"
    "aid" => "70598"
    "copyright" => "Academia Espa&#241;ola de Dermatolog&#237;a y Venereolog&#237;a and Elsevier Espa&#241;a&#44; S&#46;L&#46;"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Actas Dermosifiliogr. 2010;101:119-28"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3020
      "formatos" => array:3 [
        "EPUB" => 39
        "HTML" => 1920
        "PDF" => 1061
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Controversies in Dermatology</span>"
      "titulo" => "Primary Cutaneous CD30<span class="elsevierStyleSup">&#43;</span> Lymphoproliferative Disorders"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "119"
          "paginaFinal" => "128"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "S&#237;ndrome linfoproliferativo CD30<span class="elsevierStyleSup">&#43;</span> cut&#225;neo primario"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "L&#46; Calzado-Villarreal, I&#46; Polo-Rodr&#237;guez, P&#46;L&#46; Ortiz-Romero"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Calzado-Villarreal"
            ]
            1 => array:2 [
              "nombre" => "I&#46;"
              "apellidos" => "Polo-Rodr&#237;guez"
            ]
            2 => array:2 [
              "nombre" => "P&#46;L&#46;"
              "apellidos" => "Ortiz-Romero"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219010705989?idApp=UINPBA000044"
    "url" => "/15782190/0000010100000002/v1_201304241515/S1578219010705989/v1_201304241515/en/main.assets"
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Consensus Statement</span>"
    "titulo" => "Initial Evaluation&#44; Diagnosis&#44; Staging&#44; Treatment&#44; and Follow-up of Patients with Primary Cutaneous Malignant Melanoma&#46; Consensus Statement of the Network of Catalan and Balearic Melanoma Centers"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "129"
        "paginaFinal" => "142"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "C&#46; Mangas, C&#46; Paradelo, S&#46; Puig, F&#46; Gallardo, J&#46; Marcoval, A&#46; Azon, R&#46; Bartralot, S&#46; Bel, X&#46; Bigat&#224;, N&#46; Curc&#243;, J&#46; Dalmau, L&#46;J&#46; del Pozo, C&#46; Ferr&#225;ndiz, M&#46; Formig&#243;n, A&#46; Gonz&#225;lez, M&#46; Just, A&#46; Llambrich, E&#46; Llistosella, J&#46; Malvehy, R&#46;M&#46; Mart&#237;, M&#46;E&#46; Nogu&#233;s, R&#46; Pedragosa, V&#46; Rocamora, M&#46; S&#224;bat, M&#46; Salleras"
        "autores" => array:25 [
          0 => array:4 [
            "nombre" => "C&#46;"
            "apellidos" => "Mangas"
            "email" => array:1 [
              0 => "cris&#95;mangas&#64;yahoo&#46;es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor1"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Paradelo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "S&#46;"
            "apellidos" => "Puig"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "F&#46;"
            "apellidos" => "Gallardo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Marcoval"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff4"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Azon"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff5"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Bartralot"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff6"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "S&#46;"
            "apellidos" => "Bel"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">g</span>"
                "identificador" => "aff7"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "X&#46;"
            "apellidos" => "Bigat&#224;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">h</span>"
                "identificador" => "aff8"
              ]
            ]
          ]
          9 => array:3 [
            "nombre" => "N&#46;"
            "apellidos" => "Curc&#243;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">i</span>"
                "identificador" => "aff9"
              ]
            ]
          ]
          10 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Dalmau"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">j</span>"
                "identificador" => "aff10"
              ]
            ]
          ]
          11 => array:3 [
            "nombre" => "L&#46;J&#46;"
            "apellidos" => "del Pozo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">k</span>"
                "identificador" => "aff11"
              ]
            ]
          ]
          12 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Ferr&#225;ndiz"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          13 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Formig&#243;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">l</span>"
                "identificador" => "aff12"
              ]
            ]
          ]
          14 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Gonz&#225;lez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">m</span>"
                "identificador" => "aff13"
              ]
            ]
          ]
          15 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Just"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">n</span>"
                "identificador" => "aff14"
              ]
            ]
          ]
          16 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Llambrich"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">o</span>"
                "identificador" => "aff15"
              ]
            ]
          ]
          17 => array:3 [
            "nombre" => "E&#46;"
            "apellidos" => "Llistosella"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">p</span>"
                "identificador" => "aff16"
              ]
            ]
          ]
          18 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Malvehy"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">q</span>"
                "identificador" => "aff17"
              ]
            ]
          ]
          19 => array:3 [
            "nombre" => "R&#46;M&#46;"
            "apellidos" => "Mart&#237;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">r</span>"
                "identificador" => "aff18"
              ]
            ]
          ]
          20 => array:3 [
            "nombre" => "M&#46;E&#46;"
            "apellidos" => "Nogu&#233;s"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">s</span>"
                "identificador" => "aff19"
              ]
            ]
          ]
          21 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Pedragosa"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">t</span>"
                "identificador" => "aff20"
              ]
            ]
          ]
          22 => array:3 [
            "nombre" => "V&#46;"
            "apellidos" => "Rocamora"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">u</span>"
                "identificador" => "aff21"
              ]
            ]
          ]
          23 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "S&#224;bat"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">v</span>"
                "identificador" => "aff22"
              ]
            ]
          ]
          24 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Salleras"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">w</span>"
                "identificador" => "aff23"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:23 [
          0 => array:3 [
            "entidad" => "Hospital Universitari Germans Trias i Pujol&#44; Badalona&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "aff1"
          ]
          1 => array:3 [
            "entidad" => "Unitat de Melanoma&#44; Hospital Cl&#237;nic i Provincial de Barcelona&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "aff2"
          ]
          2 => array:3 [
            "entidad" => "Hospital del Mar&#44; IMIM&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "aff3"
          ]
          3 => array:3 [
            "entidad" => "Hospital Universitari de Bellvitge&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">d</span>"
            "identificador" => "aff4"
          ]
          4 => array:3 [
            "entidad" => "Hospital Sant Joan de Reus&#44; Reus&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">e</span>"
            "identificador" => "aff5"
          ]
          5 => array:3 [
            "entidad" => "Hospital Vall d&#8217;Hebron&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">f</span>"
            "identificador" => "aff6"
          ]
          6 => array:3 [
            "entidad" => "Hospital Comarcal d&#8217;Amposta&#44; Amposta&#44; Tarragona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">g</span>"
            "identificador" => "aff7"
          ]
          7 => array:3 [
            "entidad" => "Hospital de Matar&#243;&#44; Matar&#243;&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">h</span>"
            "identificador" => "aff8"
          ]
          8 => array:3 [
            "entidad" => "Hospital M&#250;tua de Terrassa&#44; Terrassa&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">i</span>"
            "identificador" => "aff9"
          ]
          9 => array:3 [
            "entidad" => "Hospital Santa Creu i Sant Pau&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">j</span>"
            "identificador" => "aff10"
          ]
          10 => array:3 [
            "entidad" => "Hospital Universitari Son Dureta&#44; Palma de Mallorca&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">k</span>"
            "identificador" => "aff11"
          ]
          11 => array:3 [
            "entidad" => "Consorci Sanitari de Terrassa&#44; Terrassa&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">l</span>"
            "identificador" => "aff12"
          ]
          12 => array:3 [
            "entidad" => "Consorci Sanitari Integral&#44; L&#8217;Hospitalet de Llobregat&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">m</span>"
            "identificador" => "aff13"
          ]
          13 => array:3 [
            "entidad" => "Hospital de Figueres&#44; Figueres&#44; Girona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">n</span>"
            "identificador" => "aff14"
          ]
          14 => array:3 [
            "entidad" => "Hospital Son Ll&#224;tzer&#44; Palma de Mallorca&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">o</span>"
            "identificador" => "aff15"
          ]
          15 => array:3 [
            "entidad" => "Hospital Universitari Dr&#46; Josep Trueta&#44; Girona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">p</span>"
            "identificador" => "aff16"
          ]
          16 => array:3 [
            "entidad" => "Hospital Cl&#237;nic i Provincial de Barcelona&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">q</span>"
            "identificador" => "aff17"
          ]
          17 => array:3 [
            "entidad" => "Hospital Universitari Arnau de Vilanova&#44; Lleida&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">r</span>"
            "identificador" => "aff18"
          ]
          18 => array:3 [
            "entidad" => "Hospital d&#8217;Igualada&#44; Igualada&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">s</span>"
            "identificador" => "aff19"
          ]
          19 => array:3 [
            "entidad" => "Hospital Plat&#243;&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">t</span>"
            "identificador" => "aff20"
          ]
          20 => array:3 [
            "entidad" => "Hospital de Manacor&#44; Manacor&#44; Mallorca&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">u</span>"
            "identificador" => "aff21"
          ]
          21 => array:3 [
            "entidad" => "Hospital ParcTaul&#237;&#44; Sabadell&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">v</span>"
            "identificador" => "aff22"
          ]
          22 => array:3 [
            "entidad" => "Hospital Sagrat Cor&#44; Barcelona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">w</span>"
            "identificador" => "aff23"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Valoraci&#243;n inicial&#44; diagn&#243;stico&#44; estadificaci&#243;n&#44; tratamiento y seguimiento de los pacientes con melanoma maligno primario de la piel&#46; Documento de consenso de la &#8220;Xarxa de Centres de Melanoma de Catalunya i Balears&#8221;"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec84682"
          "palabras" => array:3 [
            0 => "Melanoma"
            1 => "Consensus statement"
            2 => "Management"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec84683"
          "palabras" => array:3 [
            0 => "Melanoma"
            1 => "Documento de consenso"
            2 => "Manejo"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">This consensus statement on the management of primary cutaneous melanoma that we present here was based on selection&#44; discussion&#44; review&#44; and comparison of recent literature &#40;including national and international guidelines&#41;&#46; The protocols for the diagnosis&#44; treatment&#44; and follow-up used in the hospital centers throughout Catalonia and the Balearic Isles belonging to the Network of Catalan and Balearic Melanoma Centers were also considered&#46; The main objective of this statement was to present the overall management of melanoma patients typically used in our region at the present time&#46; As such&#44; the statement was not designed to be an obligatory protocol for health professionals caring for this group of patients&#44; and neither can it nor should it be used for this purpose&#46; Professionals reading the statement should not therefore consider it binding on their practice&#44; and in no case can this text be used to guarantee or seek responsibility for a given medical opinion&#46; The group of dermatologists who have signed this statement was created 3 years ago with the aim of making our authorities aware of the importance of this complex tumor&#44; which&#44; in comparison with other types of cancer&#44; we believe does not receive sufficient attention in Spain&#46; In addition&#44; the regular meetings of the group have produced interesting proposals for collaboration in various epidemiological&#44; clinical&#44; and basic applied research projects on the subject of malignant melanoma in our society&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">El documento de consenso respecto al manejo del melanoma primario de la piel&#44; que detallamos a continuaci&#243;n&#44; nace de la puesta en com&#250;n&#44; aceptaci&#243;n&#44; revisi&#243;n y confrontaci&#243;n con la literatura reciente &#40;incluyendo gu&#237;as cl&#237;nicas nacionales e internacionales&#41;&#44; as&#237; como de los protocolos de diagn&#243;stico&#44; seguimiento y tratamiento consensuados en los diferentes centros hospitalarios de toda Catalu&#241;a y Baleares pertenecientes a la Xarxa de Centres de Melanoma de Catalunya i Balears&#46; El objetivo principal de este documento es exponer de forma conjunta el manejo habitual del paciente con melanoma que actualmente se realiza en nuestro medio&#46; Sin embargo&#44; este documento no pretende&#44; ni puede&#44; por lo que tampoco debiera ser usado como un protocolo de obligado cumplimiento por los profesionales que atendemos a este grupo de enfermos&#46; En este sentido&#44; cabe mencionar que la consulta de este documento por parte del profesional no es vinculante para su acci&#243;n&#44; y en ning&#250;n caso este texto podr&#225; ser utilizado para garantizar o buscar responsabilidades del juicio m&#233;dico concreto&#46; El grupo de dermat&#243;logos que firman dicho documento se form&#243; hace ahora tres a&#241;os&#44; con la intenci&#243;n de dar a conocer a nuestras autoridades la importancia de este complejo tumor&#44; que en nuestro pa&#237;s creemos que se encuentra err&#243;neamente infravalorada con respecto a otros tipo de c&#225;ncer&#46; Adem&#225;s&#44; fruto de las reuniones peri&#243;dicas del grupo&#44; han surgido tambi&#233;n interesantes propuestas de colaboraci&#243;n en distintos proyectos de investigaci&#243;n epidemiol&#243;gica&#44; cl&#237;nica y b&#225;sica aplicada en torno al melanoma maligno en nuestra sociedad&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:119 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epiluminescence microscopy for the diagnosis of doubtful melanocytic skin lesions"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1998"
                        "volumen" => "134"
                        "paginaInicial" => "1563"
                        "paginaFinal" => "1570"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is dermoscopy useful for the diagnosis of melanoma&#63; Results of a meta-analysis using techniques adapted to the evaluation of the diagnostic tests"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "2001"
                        "volumen" => "137"
                        "paginaInicial" => "1343"
                        "paginaFinal" => "1350"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Melanomas that failed dermoscopic detection&#58; a combined clinicodermoscopic approach for not missing melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1524-4725.2007.33264.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Dermatol Surg"
                        "fecha" => "2007"
                        "volumen" => "33"
                        "paginaInicial" => "1262"
                        "paginaFinal" => "1273"
                        "link" => array:1 [ …1]
                        "itemHostRev" => array:3 [ …3]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Follow up of melanocytic skin lesions with digital dermoscopy"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol"
                        "fecha" => "2002"
                        "volumen" => "20"
                        "paginaInicial" => "297"
                        "paginaFinal" => "304"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Malignant melanoma in the 21st century&#44; part 1&#58; epidemiology&#44; risk factors&#44; screening&#44; prevention&#44; and diagnosis"
                      "autores" => array:1 [
                        0 => array:3 [ …3]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4065/82.3.364"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mayo Clin Proc"
                        "fecha" => "2007"
                        "volumen" => "82"
                        "paginaInicial" => "364"
                        "paginaFinal" => "380"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of cutaneous melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMra041245"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2004"
                        "volumen" => "351"
                        "paginaInicial" => "998"
                        "paginaFinal" => "1012"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evidence-based and interdisciplinary consensus-based German guidelines&#58; systemic medical treatment of melanoma in the adjuvant and palliative setting"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CMR.0b013e3282f702bf"
                      "Revista" => array:6 [
                        "tituloSerie" => "Melanoma Res"
                        "fecha" => "2008"
                        "volumen" => "18"
                        "paginaInicial" => "152"
                        "paginaFinal" => "160"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Clinical Practice Guidelines in Oncology&#46; Melanoma&#46; V&#46;2&#46;2008&#46; National Comprehensive Cancer Network &#40;NCCN&#41;&#46; Available from&#58; <a class="elsevierStyleInterRef" href="http://www.nccn.org/professionals/physician_gls/PDF/melanoma.pdf">www&#46;nccn&#46;org&#47;professionals&#47;physician&#95;gls&#47;PDF&#47;melanoma&#46;pdf</a>&#46;"
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Australian CancerNetwork&#46; Melanoma Guidelines Revision Working Party&#46; Clinical Practice Guidelines for the Management of Melanoma in Australia and New Zealand&#46; Cancer Council Australia and Australian Cancer Network&#44; Sydney and New Zealand Guidelines Group&#44; Wellington &#40;2008&#41;&#46; Available from&#58; <a class="elsevierStyleInterRef" href="http://www.cancer.org.au/">www&#46;cancer&#46;org&#46;au</a>&#46;"
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Gu&#237;a de Prevenci&#243;n y Tratamiento del Melanoma Cut&#225;neo de la Comunidad Valenciana&#44; Valencia &#40;2006&#41;&#46; Available from&#58; <a class="elsevierStyleInterRef" href="http://www.biblioteca.sp.san.gva.es/">www&#46;biblioteca&#46;sp&#46;san&#46;gva&#46;es</a>&#46;"
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "CDKN2A mutations in Spanish cutaneous malignant melanoma families and patients with multiple melanomas and other neoplasia"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Med Genet"
                        "fecha" => "1999"
                        "volumen" => "36"
                        "paginaInicial" => "490"
                        "paginaFinal" => "494"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A melanoma-associated germline mutation in exon 1&#946; inactivates p14ARF"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/sj.onc.1204728"
                      "Revista" => array:6 [
                        "tituloSerie" => "Oncogene"
                        "fecha" => "2001"
                        "volumen" => "20"
                        "paginaInicial" => "5543"
                        "paginaFinal" => "5547"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Melanoma Genetics Consortium &#40;GenoMEL&#41;&#46; High-risk melanoma susceptibility genes and pancreatic cancer&#44; neural system tumors&#44; and uveal melanoma across GenoMEL"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1158/0008-5472.CAN-06-0494"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Res"
                        "fecha" => "2006"
                        "volumen" => "66"
                        "paginaInicial" => "9818"
                        "paginaFinal" => "9828"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Features associated with germline CDKN2A mutations&#58; A GenoMEL study of melanoma-prone families from three continents"
                      "autores" => array:1 [
                        0 => array:3 [ …3]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/jmg.2006.043802"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Med Genet"
                        "fecha" => "2007"
                        "volumen" => "44"
                        "paginaInicial" => "99"
                        "paginaFinal" => "106"
                        "link" => array:1 [ …1]
                        "itemHostRev" => array:3 [ …3]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous phenotype and MC1R variants as modifying factors for the development of melanoma in CDKN2A G101W mutation carriers from 4 countries"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ijc.22712"
                      "Revista" => array:7 [
                        "tituloSerie" => "Int J Cancer"
                        "fecha" => "2007"
                        "volumen" => "121"
                        "paginaInicial" => "825"
                        "paginaFinal" => "831"
                        "link" => array:1 [ …1]
                        "itemHostRev" => array:3 [ …3]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of the CDKN2A locus in patients with multiple primary melanomas"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/JCO.2005.08.034"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Oncol"
                        "fecha" => "2005"
                        "volumen" => "23"
                        "paginaInicial" => "3043"
                        "paginaFinal" => "3051"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermoscopy report&#58; Proposal for standardization Results of a consensus meeting of the International Dermoscopy Society"
                      "autores" => array:1 [
                        0 => array:3 [ …3]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2006.02.051"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2007"
                        "volumen" => "57"
                        "paginaInicial" => "84"
                        "paginaFinal" => "95"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Protocolo de informe anatomopatol&#243;gico del melanoma primario de la piel&#46; Available from&#58; <a class="elsevierStyleInterRef" href="http://www.academia.cat/societats/anatomia/proto.htm">www&#46;academia&#46;cat&#47;societats&#47;anatomia&#47;proto&#46;htm</a>&#46;"
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Propuesta de protocolo para el informe histol&#243;gico del tumor primario de los pacientes con un melanoma cut&#225;neo del Grupo de Trabajo para el Melanoma Cut&#225;neo de la Comunidad Valenciana"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2007"
                        "volumen" => "98"
                        "paginaInicial" => "459"
                        "paginaFinal" => "465"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Final version of 2009 AJCC melanoma staging and classification"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/JCO.2009.23.4799"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Clin Oncol"
                        "fecha" => "2009"
                        "volumen" => "27"
                        "numero" => "36"
                        "paginaInicial" => "6199"
                        "paginaFinal" => "6206"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Technical details of intraoperative lymphatic mapping for early stage melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Surg"
                        "fecha" => "1992"
                        "volumen" => "127"
                        "paginaInicial" => "392"
                        "paginaFinal" => "399"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "AJCC Cancer Staging Manual"
                        "paginaInicial" => "209"
                        "paginaFinal" => "217"
                        "edicion" => "6th ed&#46;"
                        "serieFecha" => "2002"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(05)17951-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2005"
                        "volumen" => "365"
                        "paginaInicial" => "687"
                        "paginaFinal" => "701"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An evidence-based staging system for cutaneous melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "CA Cancer J Clin"
                        "fecha" => "2004"
                        "volumen" => "54"
                        "paginaInicial" => "131"
                        "paginaFinal" => "149"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sentinel node biopsy has no benefit for patients whose primary cutaneous melanoma has metastasized to a lymph node and therefore should be abandoned now"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.2004.06132.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2004"
                        "volumen" => "151"
                        "paginaInicial" => "298"
                        "paginaFinal" => "307"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sentinel lymph node biopsy for melanoma&#58; controversy despite widespread agreement"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/jco.2001.19.11.2851"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Oncol"
                        "fecha" => "2001"
                        "volumen" => "19"
                        "paginaInicial" => "2851"
                        "paginaFinal" => "2855"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sentinel node biopsy or nodal observation in melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa060992"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2006"
                        "volumen" => "355"
                        "paginaInicial" => "1307"
                        "paginaFinal" => "1317"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The argument against sentinel node biopsy for malignant melanoma&#46; Its use should be confined to patients in clinical trials"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Br Med J"
                        "fecha" => "2000"
                        "volumen" => "321"
                        "paginaInicial" => "3"
                        "paginaFinal" => "4"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sentinel node biopsy in melanoma delays recurrence but does not change melanoma-related survival-a retrospective analysis of 673 patients"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.2005.06941.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2005"
                        "volumen" => "153"
                        "paginaInicial" => "1137"
                        "paginaFinal" => "1141"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sentinel Node Biopsy for melanoma&#58; where have we been and where are we going"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg Oncol"
                        "fecha" => "2004"
                        "volumen" => "11"
                        "paginaInicial" => "147S"
                        "paginaFinal" => "151S"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La biopsia del ganglio centinela&#58; su papel diagn&#243;stico y pron&#243;stico en el melanoma maligno"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2008"
                        "volumen" => "99"
                        "paginaInicial" => "331"
                        "paginaFinal" => "348"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of preoperative ultrasound scan in detecting lymph node metastasis before sentinel node biopsy in melanoma patients"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jso.10248"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Surg Oncol"
                        "fecha" => "2003"
                        "volumen" => "83"
                        "paginaInicial" => "80"
                        "paginaFinal" => "84"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ultrasonography or palpation for detection of melanoma nodal invasion&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1470-2045(04)01609-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Oncol"
                        "fecha" => "2004"
                        "volumen" => "5"
                        "paginaInicial" => "673"
                        "paginaFinal" => "680"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib34"
              "etiqueta" => "34&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ultrasound examination of sentinel nodes in the initial assessment of patients with primary cutaneous melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10434-004-1163-3"
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Surg Oncol"
                        "fecha" => "2005"
                        "volumen" => "12"
                        "paginaInicial" => "18"
                        "paginaFinal" => "23"
                        "link" => array:1 [ …1]
                        "itemHostRev" => array:3 [ …3]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib35"
              "etiqueta" => "35&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factores pron&#243;sticos en el melanoma maligno cut&#225;neo localizado&#58; estudio de 639 pacientes"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2005"
                        "volumen" => "124"
                        "paginaInicial" => "361"
                        "paginaFinal" => "367"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib36"
              "etiqueta" => "36&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Molecular diagnostics in melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2004.08.034"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2005"
                        "volumen" => "52"
                        "paginaInicial" => "743"
                        "paginaFinal" => "775"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib37"
              "etiqueta" => "37&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Progression in cutaneous malignant melanoma is associated with distinct expression profiles"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Pathol"
                        "fecha" => "2004"
                        "volumen" => "164"
                        "paginaInicial" => "193"
                        "paginaFinal" => "203"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib38"
              "etiqueta" => "38&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome in 846 cutaneous melanoma patients from a single center after a negative sentinel node biopsy"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1245/ASO.2005.10.907"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg Oncol"
                        "fecha" => "2005"
                        "volumen" => "12"
                        "paginaInicial" => "1"
                        "paginaFinal" => "11"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib39"
              "etiqueta" => "39&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Results of sentinel lymph node biopsy in patients with thin melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1245/ASO.2006.09.813"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg Oncol"
                        "fecha" => "2006"
                        "volumen" => "13"
                        "paginaInicial" => "1"
                        "paginaFinal" => "8"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib40"
              "etiqueta" => "40&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pron&#243;stico del melanoma cut&#225;neo seg&#250;n el servicio quir&#250;rgico&#58; estudio comparativo en un hospital de tercer nivel"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2006"
                        "volumen" => "97"
                        "paginaInicial" => "247"
                        "paginaFinal" => "252"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib41"
              "etiqueta" => "41&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The development of optimal pathological assessment of sentinel lymph nodes for melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/path.1365"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Pathol"
                        "fecha" => "2003"
                        "volumen" => "200"
                        "paginaInicial" => "314"
                        "paginaFinal" => "319"
                        "link" => array:1 [ …1]
                        "itemHostRev" => array:3 [ …3]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib42"
              "etiqueta" => "42&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characterization of micrometastatic disease in melanoma sentinel lymph nodes by enhanced pathology"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Surg Pathol"
                        "fecha" => "2005"
                        "volumen" => "29"
                        "paginaInicial" => "305"
                        "paginaFinal" => "317"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib43"
              "etiqueta" => "43&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pathologic analysis of sentinel lymph nodes in melanoma patients&#58; current and future trends"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jso.20028"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Surg Oncol"
                        "fecha" => "2004"
                        "volumen" => "85"
                        "paginaInicial" => "152"
                        "paginaFinal" => "161"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib44"
              "etiqueta" => "44&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Baseline staging in cutaneous malignant melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.0007-0963.2004.05870.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2004"
                        "volumen" => "150"
                        "paginaInicial" => "677"
                        "paginaFinal" => "686"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib45"
              "etiqueta" => "45&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of radiologic imaging at the time of initial diagnosis of stage T1b-T3b melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/cncr.22868"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "2007"
                        "volumen" => "110"
                        "paginaInicial" => "1107"
                        "paginaFinal" => "1114"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            45 => array:3 [
              "identificador" => "bib46"
              "etiqueta" => "46&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of staging chest radiographs and serum lactate dehydrogenase for localized melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2004.02.017"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2004"
                        "volumen" => "51"
                        "paginaInicial" => "399"
                        "paginaFinal" => "405"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            46 => array:3 [
              "identificador" => "bib47"
              "etiqueta" => "47&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Yield and predictors of radiologic studies for identifying distant metastases in melanoma patients with a positive sentinel lymph node biopsy"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1245/s10434-007-9399-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg Oncol"
                        "fecha" => "2007"
                        "volumen" => "14"
                        "paginaInicial" => "2133"
                        "paginaFinal" => "2140"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            47 => array:3 [
              "identificador" => "bib48"
              "etiqueta" => "48&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Desarrollo de un test para la detecci&#243;n y cuantificaci&#243;n de c&#233;lulas de melanoma en sangre perif&#233;rica mediante el an&#225;lisis del RNAm de la tirosinasa por RT-PCR y empleo de un secuenciador autom&#225;tico"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "1999"
                        "volumen" => "90"
                        "paginaInicial" => "419"
                        "paginaFinal" => "431"
                        "itemHostRev" => array:3 [ …3]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            48 => array:3 [
              "identificador" => "bib49"
              "etiqueta" => "49&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of computed tomography in the staging of primary melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/jco.1993.11.4.638"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Oncol"
                        "fecha" => "1993"
                        "volumen" => "11"
                        "paginaInicial" => "638"
                        "paginaFinal" => "643"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            49 => array:3 [
              "identificador" => "bib50"
              "etiqueta" => "50&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Utility of computed tomography and magnetic resonance imaging staging before completion lymphadenectomy in patients with sentinel lymph nodepositive melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/JCO.2006.05.6176"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Oncol"
                        "fecha" => "2006"
                        "volumen" => "24"
                        "paginaInicial" => "2858"
                        "paginaFinal" => "2865"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            50 => array:3 [
              "identificador" => "bib51"
              "etiqueta" => "51&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Routine imaging of asymptomatic melanoma patients with metastasis to sentinel lymph node rarely identifies systemic disease"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archsurg.139.8.831"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Surg"
                        "fecha" => "2004"
                        "volumen" => "139"
                        "paginaInicial" => "831"
                        "paginaFinal" => "836"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            51 => array:3 [
              "identificador" => "bib52"
              "etiqueta" => "52&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of computed tomograpy in the staging of patients with local-regional metastases of melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/jco.1995.13.8.2104"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Clin Oncol"
                        "fecha" => "1995"
                        "volumen" => "13"
                        "paginaInicial" => "2104"
                        "paginaFinal" => "2108"
                        "link" => array:1 [ …1]
                        "itemHostRev" => array:3 [ …3]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            52 => array:3 [
              "identificador" => "bib53"
              "etiqueta" => "53&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Computed tomography in staging patients with melanoma metastatic to regional nodes"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg Oncol"
                        "fecha" => "1997"
                        "volumen" => "4"
                        "paginaInicial" => "396"
                        "paginaFinal" => "402"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            53 => array:3 [
              "identificador" => "bib54"
              "etiqueta" => "54&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Imaging studies in patients with melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.soc.2007.03.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Surg Oncol Clin N Am"
                        "fecha" => "2007"
                        "volumen" => "16"
                        "paginaInicial" => "403"
                        "paginaFinal" => "430"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            54 => array:3 [
              "identificador" => "bib55"
              "etiqueta" => "55&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Utility of fluorodeoxyglucose F18 positron emission tomography in initial evaluation of patients with T2 to T4 melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archsurg.141.3.284"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Surg"
                        "fecha" => "2006"
                        "volumen" => "141"
                        "paginaInicial" => "284"
                        "paginaFinal" => "288"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            55 => array:3 [
              "identificador" => "bib56"
              "etiqueta" => "56&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inefficacy of F-18 fluorodeoxy-D-glucose-positron emission tomography scans for initial evaluation in early-stage cutaneous melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/cncr.21189"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "2005"
                        "volumen" => "104"
                        "paginaInicial" => "570"
                        "paginaFinal" => "579"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            56 => array:3 [
              "identificador" => "bib57"
              "etiqueta" => "57&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "F-18 fluorodeoxy-D-glucose positron emission tomography scan in the initial evaluation of patients with a primary melanoma thicker than 4 mm"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CMR.0b013e32815c10b0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Melanoma Res"
                        "fecha" => "2007"
                        "volumen" => "17"
                        "paginaInicial" => "147"
                        "paginaFinal" => "154"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            57 => array:3 [
              "identificador" => "bib58"
              "etiqueta" => "58&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Utility of preoperative 18F-fluorodeoxyglucose-positron emission tomography scanning in high-risk melanoma patients"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1245/ASO.2006.02.008"
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Surg Oncol"
                        "fecha" => "2006"
                        "volumen" => "13"
                        "paginaInicial" => "525"
                        "paginaFinal" => "532"
                        "link" => array:1 [ …1]
                        "itemHostRev" => array:3 [ …3]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            58 => array:3 [
              "identificador" => "bib59"
              "etiqueta" => "59&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Positron emission tomography for staging and management of malignant melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1046/j.0007-1323.2002.02059.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Br J Surg"
                        "fecha" => "2002"
                        "volumen" => "89"
                        "paginaInicial" => "389"
                        "paginaFinal" => "396"
                        "link" => array:1 [ …1]
                        "itemHostRev" => array:3 [ …3]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            59 => array:3 [
              "identificador" => "bib60"
              "etiqueta" => "60&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thin stage I primary cutaneous malignant melanoma&#46; Comparison of excision with margins of 1 or 3 cm"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM198805053181804"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1988"
                        "volumen" => "318"
                        "paginaInicial" => "1159"
                        "paginaFinal" => "1162"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            60 => array:3 [
              "identificador" => "bib61"
              "etiqueta" => "61&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Narrow excision &#40;1-cm margin&#41;&#46; A safe procedure for thin cutaneous melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Surg"
                        "fecha" => "1991"
                        "volumen" => "126"
                        "paginaInicial" => "438"
                        "paginaFinal" => "441"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            61 => array:3 [
              "identificador" => "bib62"
              "etiqueta" => "62&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy of 2-cm surgical margins for intermediate-thickness melanomas &#40;1 to 4mm&#41;&#46; Results of a multi-institutional randomized surgical trial"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg"
                        "fecha" => "1993"
                        "volumen" => "218"
                        "paginaInicial" => "262"
                        "paginaFinal" => "269"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            62 => array:3 [
              "identificador" => "bib63"
              "etiqueta" => "63&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surgical margins and prognostic factors in patients with thick &#40;&#62;4 mm&#41; primary melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg Oncol"
                        "fecha" => "1998"
                        "volumen" => "5"
                        "paginaInicial" => "322"
                        "paginaFinal" => "328"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            63 => array:3 [
              "identificador" => "bib64"
              "etiqueta" => "64&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long term results of a randomized study by the Swedish Melanoma Study Group on 2-cm versus 5-cm resection margins for patients with cutaneous melanoma with a tumor thickness of 0&#46;8-2&#46;0mm"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "2000"
                        "volumen" => "89"
                        "paginaInicial" => "1495"
                        "paginaFinal" => "1501"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            64 => array:3 [
              "identificador" => "bib65"
              "etiqueta" => "65&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term results of a prospective surgical trial comparing 2 cm vs&#46; 4 cm excision margins for 740 patients with 1-4 mm melanomas"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg Oncol"
                        "fecha" => "2001"
                        "volumen" => "8"
                        "paginaInicial" => "101"
                        "paginaFinal" => "108"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            65 => array:3 [
              "identificador" => "bib66"
              "etiqueta" => "66&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "French Group of Research on Malignant Melanoma&#46; Surgical margins in cutaneous melanoma &#40;2 cm versus 5 cm for lesions measuring less than 2&#46;1 mm thick&#41;"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/cncr.11272"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "2003"
                        "volumen" => "97"
                        "paginaInicial" => "1941"
                        "paginaFinal" => "1946"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            66 => array:3 [
              "identificador" => "bib67"
              "etiqueta" => "67&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Optimal excision margins for primary cutanous melanoma&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Surg"
                        "fecha" => "2003"
                        "volumen" => "46"
                        "paginaInicial" => "419"
                        "paginaFinal" => "426"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            67 => array:3 [
              "identificador" => "bib68"
              "etiqueta" => "68&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Excision margins in high-risk malignant melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa030681"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2004"
                        "volumen" => "350"
                        "paginaInicial" => "757"
                        "paginaFinal" => "766"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            68 => array:3 [
              "identificador" => "bib69"
              "etiqueta" => "69&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thumb reconstruction following resection for malignant tumors"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.prs.0000304590.09003.1b"
                      "Revista" => array:6 [
                        "tituloSerie" => "Plast Reconstr Surg"
                        "fecha" => "2008"
                        "volumen" => "121"
                        "paginaInicial" => "1279"
                        "paginaFinal" => "1287"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            69 => array:3 [
              "identificador" => "bib70"
              "etiqueta" => "70&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mohs micrographic surgery for the treatment of primary cutaneous melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "1997"
                        "volumen" => "37"
                        "paginaInicial" => "236"
                        "paginaFinal" => "245"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            70 => array:3 [
              "identificador" => "bib71"
              "etiqueta" => "71&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mohs surgery for the treatment of melanoma in situ&#58; a review"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1524-4725.2007.33085.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatol Surg"
                        "fecha" => "2007"
                        "volumen" => "33"
                        "paginaInicial" => "395"
                        "paginaFinal" => "402"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            71 => array:3 [
              "identificador" => "bib72"
              "etiqueta" => "72&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The treatment of nail apparatus melanoma with Mohs micrographic surgery"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatol Surg"
                        "fecha" => "2001"
                        "volumen" => "27"
                        "paginaInicial" => "269"
                        "paginaFinal" => "273"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            72 => array:3 [
              "identificador" => "bib73"
              "etiqueta" => "73&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dispelling the myths surrounding radiotherapy for treatment of cutaneous melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1470-2045(06)70758-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Oncol"
                        "fecha" => "2006"
                        "volumen" => "7"
                        "paginaInicial" => "575"
                        "paginaFinal" => "583"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            73 => array:3 [
              "identificador" => "bib74"
              "etiqueta" => "74&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Radiation therapy in the management of cutaneous melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.soc.2005.12.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Surg Oncol Clin N Am"
                        "fecha" => "2006"
                        "volumen" => "15"
                        "paginaInicial" => "353"
                        "paginaFinal" => "371"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            74 => array:3 [
              "identificador" => "bib75"
              "etiqueta" => "75&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Radiation therapy as primary and adjuvant treatment for local and regional melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Control"
                        "fecha" => "2008"
                        "volumen" => "15"
                        "paginaInicial" => "233"
                        "paginaFinal" => "238"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            75 => array:3 [
              "identificador" => "bib76"
              "etiqueta" => "76&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Toxicity of combined treatment of adjuvant irradiation and interferon alpha2b in high-risk melanoma patients"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CMR.0b013e3282c3a6ed"
                      "Revista" => array:6 [
                        "tituloSerie" => "Melanoma Res"
                        "fecha" => "2007"
                        "volumen" => "17"
                        "paginaInicial" => "304"
                        "paginaFinal" => "309"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            76 => array:3 [
              "identificador" => "bib77"
              "etiqueta" => "77&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interferon alfa-2b adjuvant therapy of high-risk resected cutaneous melanoma&#58; the Eastern Cooperative Oncology Group Trial EST 1684"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/jco.1996.14.1.7"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Oncol"
                        "fecha" => "1996"
                        "volumen" => "14"
                        "paginaInicial" => "7"
                        "paginaFinal" => "17"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            77 => array:3 [
              "identificador" => "bib78"
              "etiqueta" => "78&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Randomized trial of interferon alpha-2a as adjuvant therapy in resected primary melanoma thicker than 1&#46;5 mm without clinically detectable node metastases&#46; French Cooperative Group on Melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1998"
                        "volumen" => "351"
                        "paginaInicial" => "1905"
                        "paginaFinal" => "1910"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            78 => array:3 [
              "identificador" => "bib79"
              "etiqueta" => "79&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adjuvant interferon alfa-2a treatment in resected primary stage II cutaneous melanoma&#46; Austrian Malignant Melanoma Cooperative Group"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/jco.1998.16.4.1425"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Oncol"
                        "fecha" => "1998"
                        "volumen" => "16"
                        "paginaInicial" => "1425"
                        "paginaFinal" => "1429"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            79 => array:3 [
              "identificador" => "bib80"
              "etiqueta" => "80&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High- and low-dose interferon alfa-2b in high-risk melanoma&#58; first analysis of intergroup trial E1690&#47;S9111&#47;C9190"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/jco.2000.18.12.2444"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Oncol"
                        "fecha" => "2000"
                        "volumen" => "18"
                        "paginaInicial" => "2444"
                        "paginaFinal" => "2458"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            80 => array:3 [
              "identificador" => "bib81"
              "etiqueta" => "81&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High-dose interferon alfa-2b does not diminish antibody response to GM2 vaccination in patients with resected melanoma&#58; results of the Multicenter Eastern Cooperative Oncology Group Phase II Trial E2696"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/jco.2001.19.5.1430"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Oncol"
                        "fecha" => "2001"
                        "volumen" => "19"
                        "paginaInicial" => "1430"
                        "paginaFinal" => "1436"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            81 => array:3 [
              "identificador" => "bib82"
              "etiqueta" => "82&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of long term adjuvant therapy with interferon alpha-2a in patients with regional node metastases from cutaneous melanoma&#58; a randomized trial"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(01)06068-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2001"
                        "volumen" => "358"
                        "paginaInicial" => "866"
                        "paginaFinal" => "869"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            82 => array:3 [
              "identificador" => "bib83"
              "etiqueta" => "83&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interferon alpha therapy for malignant melanoma&#58; a systematic review of randomized clinical trials"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/JCO.2002.07.070"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Oncol"
                        "fecha" => "2002"
                        "volumen" => "20"
                        "paginaInicial" => "1818"
                        "paginaFinal" => "1825"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            83 => array:3 [
              "identificador" => "bib84"
              "etiqueta" => "84&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adjuvant interferon in high-risk melanoma&#58; the AIM HIGH Study--United Kingdom Coordinating Committee on Cancer Research randomized study of adjuvant low-dose extended-duration interferon Alfa-2a in high-risk resected malignant melanoma"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/JCO.2004.03.185"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Clin Oncol"
                         …6
                      ]
                    ]
                  ]
                ]
              ]
            ]
            84 => array:3 [
              "identificador" => "bib85"
              "etiqueta" => "85&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A pooled analysis of eastern cooperative oncology group and intergroup trials of adjuvant high dose interferon for melanoma"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            85 => array:3 [
              "identificador" => "bib86"
              "etiqueta" => "86&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Post-surgery adjuvant therapy with intermediate doses of interferon alfa 2b versus observation in patients with stage IIb&#47;III melanoma &#40;EORTC 18952&#41;&#58; randomized controlled trial"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(05)67482-X"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            86 => array:3 [
              "identificador" => "bib87"
              "etiqueta" => "87&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adjuvant therapy with pegylated interferon alfa-2b versus observation alone in resected stage III melanoma&#58; final results of EORTC 18991&#44; a randomised phase III trial"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(08)61033-8"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            87 => array:3 [
              "identificador" => "bib88"
              "etiqueta" => "88&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Controversias sobre el interfer&#243;n en el tratamiento adyuvante del melanoma"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            88 => array:3 [
              "identificador" => "bib89"
              "etiqueta" => "89&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surgical therapy of cutaneous melanoma"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/j.seminoncol.2007.03.007"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            89 => array:3 [
              "identificador" => "bib90"
              "etiqueta" => "90&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical outcome after surgical resection of lung metastases from melanoma"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            90 => array:3 [
              "identificador" => "bib91"
              "etiqueta" => "91&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Does complete resection of melanoma metastatic to solid intra-abdominal organs improve survival&#63;"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            91 => array:3 [
              "identificador" => "bib92"
              "etiqueta" => "92&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Temozolomida en pacientes con met&#225;stasis cerebrales de melanoma tratados con irradiaci&#243;n holocraneal"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            92 => array:3 [
              "identificador" => "bib93"
              "etiqueta" => "93&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Isolated limb perfusion for melanoma patients--a review of its indications and the role of tumour necrosis factor-alpha"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejso.2006.01.015"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            93 => array:3 [
              "identificador" => "bib94"
              "etiqueta" => "94&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of metastatic melanoma"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/j.seminoncol.2007.09.008"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            94 => array:3 [
              "identificador" => "bib95"
              "etiqueta" => "95&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Temozolomide for the treatment of metastatic melanoma&#58; a systematic review"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1634/theoncologist.12-9-1114"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            95 => array:3 [
              "identificador" => "bib96"
              "etiqueta" => "96&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Temozolomide as prophylaxis for melanoma brain metastases"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            96 => array:3 [
              "identificador" => "bib97"
              "etiqueta" => "97&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fotemustine compared with dacarbazine in patients with disseminated malignant melanoma&#58; a phase III study"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/JCO.2004.04.165"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            97 => array:3 [
              "identificador" => "bib98"
              "etiqueta" => "98&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systemic chemotherapy in the treatment of malignant melanoma"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1517/14656566.4.12.2205"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            98 => array:3 [
              "identificador" => "bib99"
              "etiqueta" => "99&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Single-agent interleukin-2 in the treatment of metastatic melanoma"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            99 => array:3 [
              "identificador" => "bib100"
              "etiqueta" => "100&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Human leukocyte &#40;alpha&#41; interferon in metastatic malignant melanoma&#58; the American Cancer Society phase II trial"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [ …7]
                    ]
                  ]
                ]
              ]
            ]
            100 => array:3 [
              "identificador" => "bib101"
              "etiqueta" => "101&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of patients with progressive unresectable metastatic melanoma with a heterologous polyvalent melanoma whole cell vaccine"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ijc.11242"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            101 => array:3 [
              "identificador" => "bib102"
              "etiqueta" => "102&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pilot study of treatment of biochemotherapy-refractory stage IV melanoma patients with autologous dendritic cells pulsed with a heterologous melanoma cell line lysate"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00262-003-0495-3"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            102 => array:3 [
              "identificador" => "bib103"
              "etiqueta" => "103&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development of a biochemotherapy regimen with concurrent administration of cisplatin&#44; vinblastine&#44; dacarbazine&#44; interferon alfa&#44; and interleukin-2 for patients with metastatic melanoma"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/jco.1998.16.5.1752"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            103 => array:3 [
              "identificador" => "bib104"
              "etiqueta" => "104&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Biochemotherapy with temozolomide&#44; cisplatin&#44; vinblastine&#44; subcutaneous interleukin-2 and interferon-alpha in patients with metastatic melanoma"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.cmr.0000195697.58013.b7"
                      "Revista" => array:7 [ …7]
                    ]
                  ]
                ]
              ]
            ]
            104 => array:3 [
              "identificador" => "bib105"
              "etiqueta" => "105&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sequential biochemotherapy versus chemotherapy for metastatic melanoma&#58; results from a phase III randomized trial"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/JCO.2002.07.044"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            105 => array:3 [
              "identificador" => "bib106"
              "etiqueta" => "106&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous malignant melanoma&#58; ESMO clinical recommendations for diagnosis&#44; treatment and follow-up"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/annonc/mdm045"
                      "Revista" => array:7 [ …7]
                    ]
                  ]
                ]
              ]
            ]
            106 => array:3 [
              "identificador" => "bib107"
              "etiqueta" => "107&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is ultrasound lymph node examination superior to clinical examination in melanoma follow-up&#63; A monocentre cohort study of 373 patients"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            107 => array:3 [
              "identificador" => "bib108"
              "etiqueta" => "108&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Methods of detection of first recurrence in patients with stage I&#47;II primary cutaneous melanoma after sentinel lymph node biopsy"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1245/s10434-008-9985-z"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            108 => array:3 [
              "identificador" => "bib109"
              "etiqueta" => "109&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An evidence base for reconsidering current follow-up guidelines for patients with cutaneous melanoma less than 0&#46;5 mm thick at diagnosis"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.2008.08641.x"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            109 => array:3 [
              "identificador" => "bib110"
              "etiqueta" => "110&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "S-100b and MIA in Advanced Melanoma in relation to prognostic factors"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            110 => array:3 [
              "identificador" => "bib111"
              "etiqueta" => "111&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prognostic implications of protein S-100 beta serum levels in the clinical outcome of high-risk melanoma patients"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000110424"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            111 => array:3 [
              "identificador" => "bib112"
              "etiqueta" => "112&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Melanoma inhibiting activity protein &#40;MIA&#41;&#44; beta-2 microglobulin and lactate dehydrogenase &#40;LDH&#41; in metastatic melanoma"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            112 => array:3 [
              "identificador" => "bib113"
              "etiqueta" => "113&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The National Cancer Data Base report on cutaneous and noncutaneous melanoma&#58; a summary of 84&#44;836 cases from the past decade&#46; The American College of Surgeons Commission on Cancer and the American Cancer Society"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            113 => array:3 [
              "identificador" => "bib114"
              "etiqueta" => "114&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Melanoma of unknown primary&#58; experience at Massachusetts General Hospital and Dana-Farber Cancer Institute"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            114 => array:3 [
              "identificador" => "bib115"
              "etiqueta" => "115&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Survival of patients with visceral metastatic melanoma from an occult primary lesion&#58; a retrospective matched cohort study"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            115 => array:3 [
              "identificador" => "bib116"
              "etiqueta" => "116&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic and therapeutic management of cancer of an unknown primary"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            116 => array:3 [
              "identificador" => "bib117"
              "etiqueta" => "117&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "How I explore&#8230; an orphan metastasis from melanoma"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            117 => array:3 [
              "identificador" => "bib118"
              "etiqueta" => "118&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Metastatic melanoma of unknown primary origin shows prognostic similarities to regional metastatic melanoma&#58; recommendations for initial staging examinations"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            118 => array:3 [
              "identificador" => "bib119"
              "etiqueta" => "119&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of unknown primary melanoma"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010100000002/v1_201304241515/S1578219010705990/v1_201304241515/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6254"
    "tipo" => "SECCION"
    "fr" => array:2 [
      "titulo" => "Consensus statement"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "fr"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010100000002/v1_201304241515/S1578219010705990/v1_201304241515/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219010705990?idApp=UINPBA000044"
]
Share
Journal Information
Vol. 101. Issue 2.
Pages 129-142 (March 2010)
Share
Share
Download PDF
More article options
Vol. 101. Issue 2.
Pages 129-142 (March 2010)
Consensus Statement
Full text access
Initial Evaluation, Diagnosis, Staging, Treatment, and Follow-up of Patients with Primary Cutaneous Malignant Melanoma. Consensus Statement of the Network of Catalan and Balearic Melanoma Centers
Valoración inicial, diagnóstico, estadificación, tratamiento y seguimiento de los pacientes con melanoma maligno primario de la piel. Documento de consenso de la “Xarxa de Centres de Melanoma de Catalunya i Balears”
Visits
6981
C. Mangasa,
Corresponding author
cris_mangas@yahoo.es

Corresponding author.
, C. Paradeloa, S. Puigb, F. Gallardoc, J. Marcovald, A. Azone, R. Bartralotf, S. Belg, X. Bigatàh, N. Curcói, J. Dalmauj, L.J. del Pozok, C. Ferrándiza, M. Formigónl, A. Gonzálezm, M. Justn, A. Llambricho, E. Llistosellap, J. Malvehyq, R.M. Martír..., M.E. Noguéss, R. Pedragosat, V. Rocamorau, M. Sàbatv, M. SalleraswVer más
a Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
b Unitat de Melanoma, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
c Hospital del Mar, IMIM, Barcelona, Spain
d Hospital Universitari de Bellvitge, Barcelona, Spain
e Hospital Sant Joan de Reus, Reus, Barcelona, Spain
f Hospital Vall d’Hebron, Barcelona, Spain
g Hospital Comarcal d’Amposta, Amposta, Tarragona, Spain
h Hospital de Mataró, Mataró, Barcelona, Spain
i Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain
j Hospital Santa Creu i Sant Pau, Barcelona, Spain
k Hospital Universitari Son Dureta, Palma de Mallorca, Spain
l Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain
m Consorci Sanitari Integral, L’Hospitalet de Llobregat, Barcelona, Spain
n Hospital de Figueres, Figueres, Girona, Spain
o Hospital Son Llàtzer, Palma de Mallorca, Spain
p Hospital Universitari Dr. Josep Trueta, Girona, Spain
q Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
r Hospital Universitari Arnau de Vilanova, Lleida, Spain
s Hospital d’Igualada, Igualada, Barcelona, Spain
t Hospital Plató, Barcelona, Spain
u Hospital de Manacor, Manacor, Mallorca, Spain
v Hospital ParcTaulí, Sabadell, Barcelona, Spain
w Hospital Sagrat Cor, Barcelona, Spain
Ver más
This item has received
Article information
Abstract

This consensus statement on the management of primary cutaneous melanoma that we present here was based on selection, discussion, review, and comparison of recent literature (including national and international guidelines). The protocols for the diagnosis, treatment, and follow-up used in the hospital centers throughout Catalonia and the Balearic Isles belonging to the Network of Catalan and Balearic Melanoma Centers were also considered. The main objective of this statement was to present the overall management of melanoma patients typically used in our region at the present time. As such, the statement was not designed to be an obligatory protocol for health professionals caring for this group of patients, and neither can it nor should it be used for this purpose. Professionals reading the statement should not therefore consider it binding on their practice, and in no case can this text be used to guarantee or seek responsibility for a given medical opinion. The group of dermatologists who have signed this statement was created 3 years ago with the aim of making our authorities aware of the importance of this complex tumor, which, in comparison with other types of cancer, we believe does not receive sufficient attention in Spain. In addition, the regular meetings of the group have produced interesting proposals for collaboration in various epidemiological, clinical, and basic applied research projects on the subject of malignant melanoma in our society.

Keywords:
Melanoma
Consensus statement
Management
Resumen

El documento de consenso respecto al manejo del melanoma primario de la piel, que detallamos a continuación, nace de la puesta en común, aceptación, revisión y confrontación con la literatura reciente (incluyendo guías clínicas nacionales e internacionales), así como de los protocolos de diagnóstico, seguimiento y tratamiento consensuados en los diferentes centros hospitalarios de toda Cataluña y Baleares pertenecientes a la Xarxa de Centres de Melanoma de Catalunya i Balears. El objetivo principal de este documento es exponer de forma conjunta el manejo habitual del paciente con melanoma que actualmente se realiza en nuestro medio. Sin embargo, este documento no pretende, ni puede, por lo que tampoco debiera ser usado como un protocolo de obligado cumplimiento por los profesionales que atendemos a este grupo de enfermos. En este sentido, cabe mencionar que la consulta de este documento por parte del profesional no es vinculante para su acción, y en ningún caso este texto podrá ser utilizado para garantizar o buscar responsabilidades del juicio médico concreto. El grupo de dermatólogos que firman dicho documento se formó hace ahora tres años, con la intención de dar a conocer a nuestras autoridades la importancia de este complejo tumor, que en nuestro país creemos que se encuentra erróneamente infravalorada con respecto a otros tipo de cáncer. Además, fruto de las reuniones periódicas del grupo, han surgido también interesantes propuestas de colaboración en distintos proyectos de investigación epidemiológica, clínica y básica aplicada en torno al melanoma maligno en nuestra sociedad.

Palabras clave:
Melanoma
Documento de consenso
Manejo
Full text is only aviable in PDF
References
[1.]
G. Argenziano, G. Fabbrocini, P. Carli, V. De Giorgi, E. Sammarco, M. Delfino.
Epiluminescence microscopy for the diagnosis of doubtful melanocytic skin lesions.
Arch Dermatol, 134 (1998), pp. 1563-1570
[2.]
M. Bafounta, A. Beauchet, P. Aegerter, P. Saiag.
Is dermoscopy useful for the diagnosis of melanoma? Results of a meta-analysis using techniques adapted to the evaluation of the diagnostic tests.
Arch Dermatol, 137 (2001), pp. 1343-1350
[3.]
S. Puig, G. Argenziano, I. Zalaudek, G. Ferrara, J. Palou, D. Massi, et al.
Melanomas that failed dermoscopic detection: a combined clinicodermoscopic approach for not missing melanoma.
Dermatol Surg, 33 (2007), pp. 1262-1273
[4.]
J. Malvehy, S. Puig.
Follow up of melanocytic skin lesions with digital dermoscopy.
Clin Dermatol, 20 (2002), pp. 297-304
[5.]
S.N. Markovic, L.A. Erickson, R.D. Rao, R.H. Weenig, B.A. Pockaj, A. Bardia, Melanoma Study Group of the Mayo Clinic Cancer Center, et al.
Malignant melanoma in the 21st century, part 1: epidemiology, risk factors, screening, prevention, and diagnosis.
Mayo Clin Proc, 82 (2007), pp. 364-380
[6.]
H. Tsao, M.B. Atkins, A.J. Sober.
Management of cutaneous melanoma.
N Engl J Med, 351 (2004), pp. 998-1012
[7.]
C. Garbe, A. Hauschild, M. Volkenandt, D. Schadendorf, W. Stolz, U. Reinhold, et al.
Evidence-based and interdisciplinary consensus-based German guidelines: systemic medical treatment of melanoma in the adjuvant and palliative setting.
Melanoma Res, 18 (2008), pp. 152-160
[8.]
Clinical Practice Guidelines in Oncology. Melanoma. V.2.2008. National Comprehensive Cancer Network (NCCN). Available from: www.nccn.org/professionals/physician_gls/PDF/melanoma.pdf.
[9.]
Australian CancerNetwork. Melanoma Guidelines Revision Working Party. Clinical Practice Guidelines for the Management of Melanoma in Australia and New Zealand. Cancer Council Australia and Australian Cancer Network, Sydney and New Zealand Guidelines Group, Wellington (2008). Available from: www.cancer.org.au.
[10.]
Guía de Prevención y Tratamiento del Melanoma Cutáneo de la Comunidad Valenciana, Valencia (2006). Available from: www.biblioteca.sp.san.gva.es.
[11.]
A. Ruiz, S. Puig, J. Malvehy, C. Lázaro, M. Lynch, M.A. Giménez-Arnau, et al.
CDKN2A mutations in Spanish cutaneous malignant melanoma families and patients with multiple melanomas and other neoplasia.
J Med Genet, 36 (1999), pp. 490-494
[12.]
H. Rizos, S. Puig, C. Badenas, J. Malvehy, A.P. Darmanian, L. Jiménez, et al.
A melanoma-associated germline mutation in exon 1β inactivates p14ARF.
Oncogene, 20 (2001), pp. 5543-5547
[13.]
A.M. Goldstein, M. Chan, M. Harland, E.M. Gillanders, N.K. Hayward, M.F. Avril, et al.
Melanoma Genetics Consortium (GenoMEL). High-risk melanoma susceptibility genes and pancreatic cancer, neural system tumors, and uveal melanoma across GenoMEL.
Cancer Res, 66 (2006), pp. 9818-9828
[14.]
A.M. Goldstein, M. Chan, M. Harland, N.K. Hayward, F. Demenais, D.T. Bishop, M.G. Genomel, Study Group LM, et al.
Features associated with germline CDKN2A mutations: A GenoMEL study of melanoma-prone families from three continents.
J Med Genet, 44 (2007), pp. 99-106
[15.]
A.M. Goldstein, V. Chaudru, P. Ghiorzo, C. Badenas, J. Malvehy, L. Pastorino, et al.
Cutaneous phenotype and MC1R variants as modifying factors for the development of melanoma in CDKN2A G101W mutation carriers from 4 countries.
Int J Cancer, 121 (2007), pp. 825-831
[16.]
S. Puig, J. Malvehy, C. Badenas, A. Ruiz, D. Jiménez, F. Cuéllar, et al.
Role of the CDKN2A locus in patients with multiple primary melanomas.
J Clin Oncol, 23 (2005), pp. 3043-3051
[17.]
J. Malvehy, S. Puig, G. Argenziano, A.A. Marghoob, H.P. Soyer, on behalf of the International Dermoscopy Society Board members.
Dermoscopy report: Proposal for standardization Results of a consensus meeting of the International Dermoscopy Society.
J Am Acad Dermatol, 57 (2007), pp. 84-95
[18.]
Protocolo de informe anatomopatológico del melanoma primario de la piel. Available from: www.academia.cat/societats/anatomia/proto.htm.
[19.]
E. Nagore, M. Monteagudo, M.I. Pinazo, R. Botella-Estrada, V. Oliver, J. Bañuls, et al.
Propuesta de protocolo para el informe histológico del tumor primario de los pacientes con un melanoma cutáneo del Grupo de Trabajo para el Melanoma Cutáneo de la Comunidad Valenciana.
Actas Dermosifiliogr, 98 (2007), pp. 459-465
[20.]
C.M. Balch, J.E. Gershenwald, S.J. Soong, J.F. Thompson, M.B. Atkins, D.R. Byrd, et al.
Final version of 2009 AJCC melanoma staging and classification.
J Clin Oncol, 27 (2009), pp. 6199-6206
[21.]
D.L. Morton, Dr. Wen, J.H. Wong, J.S. Economou, L.A. Cagle, F.K. Storm, et al.
Technical details of intraoperative lymphatic mapping for early stage melanoma.
Arch Surg, 127 (1992), pp. 392-399
[22.]
C.M. Balch.
Cutaneous melanoma.
AJCC Cancer Staging Manual, 6th ed., pp. 209-217
[23.]
J.F. Thompson, R.A. Scoyler, R.F. Kefford.
Cutaneous melanoma.
[24.]
C.M. Balch, S. Soong, M.B. Atkins, A.C. Buzaid, N. Cascinelli, D.G. Coit, et al.
An evidence-based staging system for cutaneous melanoma.
CA Cancer J Clin, 54 (2004), pp. 131-149
[25.]
N. Medalie, A.B. Ackerman.
Sentinel node biopsy has no benefit for patients whose primary cutaneous melanoma has metastasized to a lymph node and therefore should be abandoned now.
Br J Dermatol, 151 (2004), pp. 298-307
[26.]
K.M. McMasters, D.S. Reintgen, M.I. Ross, J.E. Gershenwald, M.J. Edwards, A. Sober, et al.
Sentinel lymph node biopsy for melanoma: controversy despite widespread agreement.
J Clin Oncol, 19 (2001), pp. 2851-2855
[27.]
D.L. Morton, J.F. Thompson, A.J. Cochran, N. Mozzillo, R. Elashoff, R. Essner, et al.
Sentinel node biopsy or nodal observation in melanoma.
N Engl J Med, 355 (2006), pp. 1307-1317
[28.]
J.M. Thomas, E.J. Patocskai.
The argument against sentinel node biopsy for malignant melanoma. Its use should be confined to patients in clinical trials.
Br Med J, 321 (2000), pp. 3-4
[29.]
R. Gutzmer, M. Al-Ghazal, H. Geerlings, A. Kapp.
Sentinel node biopsy in melanoma delays recurrence but does not change melanoma-related survival-a retrospective analysis of 673 patients.
Br J Dermatol, 153 (2005), pp. 1137-1141
[30.]
J.F. Thompson, J.R. Stretch, R.F. Uren, V.S. Ka, R. Scoyler.
Sentinel Node Biopsy for melanoma: where have we been and where are we going.
Ann Surg Oncol, 11 (2004), pp. 147S-151S
[31.]
C. Mangas, C. Paradelo, J. Rex, C. Ferrándiz.
La biopsia del ganglio centinela: su papel diagnóstico y pronóstico en el melanoma maligno.
Actas Dermosifiliogr, 99 (2008), pp. 331-348
[32.]
C.R. Rossi, S. Mocellin, B. Scagnet, M. Foletto, A. Vecchiato, P. Pilati, et al.
The role of preoperative ultrasound scan in detecting lymph node metastasis before sentinel node biopsy in melanoma patients.
J Surg Oncol, 83 (2003), pp. 80-84
[33.]
M.L. Bafounta, A. Beauchet, S. Chagnon, P. Saiag.
Ultrasonography or palpation for detection of melanoma nodal invasion: a meta-analysis.
Lancet Oncol, 5 (2004), pp. 673-680
[34.]
E.C. Starritt, R.F. Uren, R.A. Scolyer, M.J. Quinn, J.F. Thompson.
Ultrasound examination of sentinel nodes in the initial assessment of patients with primary cutaneous melanoma.
Ann Surg Oncol, 12 (2005), pp. 18-23
[35.]
E. Nagore, V. Oliver, R. Botella, A. Insa, J.M. Fortea.
Factores pronósticos en el melanoma maligno cutáneo localizado: estudio de 639 pacientes.
Med Clin (Barc), 124 (2005), pp. 361-367
[36.]
J.A. Carlson, J.S. Ross, A. Slominski, G. Linette, J. Mysliborski, J. Hill, et al.
Molecular diagnostics in melanoma.
J Am Acad Dermatol, 52 (2005), pp. 743-775
[37.]
S.R. Alonso, P. Ortiz, M. Pollán, B. Pérez-Gómez, L. Sánchez, M.J. Acuña, et al.
Progression in cutaneous malignant melanoma is associated with distinct expression profiles.
Am J Pathol, 164 (2004), pp. 193-203
[38.]
V.S. Yee, J.F. Thompson, J.G. McKinnon, R.A. Scoyler, L.X. Li, W.H. McCarthy, et al.
Outcome in 846 cutaneous melanoma patients from a single center after a negative sentinel node biopsy.
Ann Surg Oncol, 12 (2005), pp. 1-11
[39.]
S.L. Wong, M.S. Brady, K.J. Busam, D.G. Coit.
Results of sentinel lymph node biopsy in patients with thin melanoma.
Ann Surg Oncol, 13 (2006), pp. 1-8
[40.]
J.A. Avilés, P. Lázaro.
Pronóstico del melanoma cutáneo según el servicio quirúrgico: estudio comparativo en un hospital de tercer nivel.
Actas Dermosifiliogr, 97 (2006), pp. 247-252
[41.]
M.G. Cook, M.A. Green, A. Anderson, A.M. Eggermont, D.J. Ruiter, A. Spatz, et al.
The development of optimal pathological assessment of sentinel lymph nodes for melanoma.
J Pathol, 200 (2003), pp. 314-319
[42.]
K. Spanknebel, D.G. Coit, S.C. Bieglick, M. Gonen, J. Rosai, D.S. Klimstra.
Characterization of micrometastatic disease in melanoma sentinel lymph nodes by enhanced pathology.
Am J Surg Pathol, 29 (2005), pp. 305-317
[43.]
A.A. Roberts, A.J. Cochran.
Pathologic analysis of sentinel lymph nodes in melanoma patients: current and future trends.
J Surg Oncol, 85 (2004), pp. 152-161
[44.]
J. Hafner, M.H. Schmid, W. Kempf, G. Burg, W. Künzi, C. Meuli-Simmen, et al.
Baseline staging in cutaneous malignant melanoma.
Br J Dermatol, 150 (2004), pp. 677-686
[45.]
M. Yancovitz, N. Finelt, M.A. Warycha, P.J. Christos, M. Mazumdar, R.L. Shapiro, et al.
Role of radiologic imaging at the time of initial diagnosis of stage T1b-T3b melanoma.
Cancer, 110 (2007), pp. 1107-1114
[46.]
T.S. Wang, T.M. Johnson, P.N. Cascade, B.G. Redman, V.K. Sondak, J.L. Schwartz.
Evaluation of staging chest radiographs and serum lactate dehydrogenase for localized melanoma.
J Am Acad Dermatol, 51 (2004), pp. 399-405
[47.]
J.S. Gold, D.P. Jaques, K.J. Busam, M.S. Brady, D.G. Coit.
Yield and predictors of radiologic studies for identifying distant metastases in melanoma patients with a positive sentinel lymph node biopsy.
Ann Surg Oncol, 14 (2007), pp. 2133-2140
[48.]
J. Sopena, E. Nogueira, D. Carpio, O. Sanmartín, A. Sevilla, C. Guillén.
Desarrollo de un test para la detección y cuantificación de células de melanoma en sangre periférica mediante el análisis del RNAm de la tirosinasa por RT-PCR y empleo de un secuenciador automático.
Actas Dermosifiliogr, 90 (1999), pp. 419-431
[49.]
A.C. Buzaid, A.B. Sandler, S. Mani, A.M. Curtis, W.J. Poo, J.L. Bolognia, et al.
Role of computed tomography in the staging of primary melanoma.
J Clin Oncol, 11 (1993), pp. 638-643
[50.]
T.A. Aloia, J.E. Gershenwald, R.H. Andtbacka, M.M. Johnson, C.W. Schacherer, C.S. Ng, et al.
Utility of computed tomography and magnetic resonance imaging staging before completion lymphadenectomy in patients with sentinel lymph nodepositive melanoma.
J Clin Oncol, 24 (2006), pp. 2858-2865
[51.]
E.P. Miranda, M. Gertner, J. Wall, E. Grace, M. Kashani-Sabet, R. Allen, et al.
Routine imaging of asymptomatic melanoma patients with metastasis to sentinel lymph node rarely identifies systemic disease.
Arch Surg, 139 (2004), pp. 831-836
[52.]
A.C. Buzaid, L. Tinoco, M.I. Ross, S.S. Legha, R.S. Benjamin.
Role of computed tomograpy in the staging of patients with local-regional metastases of melanoma.
J Clin Oncol, 13 (1995), pp. 2104-2108
[53.]
T.M. Johnson, D.J. Fader, A.E. Chang, A. Yahanda, J.W. Smith, K.R. Hamlet, et al.
Computed tomography in staging patients with melanoma metastatic to regional nodes.
Ann Surg Oncol, 4 (1997), pp. 396-402
[54.]
E.A. Choi, J.E. Gershenwald.
Imaging studies in patients with melanoma.
Surg Oncol Clin N Am, 16 (2007), pp. 403-430
[55.]
P.B. Clark, V. Soo, J. Kraas, P. Shen, E.A. Levine.
Utility of fluorodeoxyglucose F18 positron emission tomography in initial evaluation of patients with T2 to T4 melanoma.
Arch Surg, 141 (2006), pp. 284-288
[56.]
J.D. Wagner, D. Schauwecker, D. Davidson, T. Logan, J.J. Coleman, G. Hutchins, et al.
Inefficacy of F-18 fluorodeoxy-D-glucose-positron emission tomography scans for initial evaluation in early-stage cutaneous melanoma.
Cancer, 104 (2005), pp. 570-579
[57.]
E. Maubec, J. Lumbroso, F. Masson, V. Suciu, F. Kilb, G. Mamelle, et al.
F-18 fluorodeoxy-D-glucose positron emission tomography scan in the initial evaluation of patients with a primary melanoma thicker than 4 mm.
Melanoma Res, 17 (2007), pp. 147-154
[58.]
M.S. Brady, T. Akhurst, k. Spanknebel, S. Hilton, M. Gonen, A. Patel, et al.
Utility of preoperative 18F-fluorodeoxyglucose-positron emission tomography scanning in high-risk melanoma patients.
Ann Surg Oncol, 13 (2006), pp. 525-532
[59.]
R.S. Prichard, A.D. Hill, S.J. Skehan, N.J. O’Higgins.
Positron emission tomography for staging and management of malignant melanoma.
[60.]
U. Veronesi, N. Cascinelli, J. Adamus, C. Balch, D. Bandiera, A. Barchuk, et al.
Thin stage I primary cutaneous malignant melanoma. Comparison of excision with margins of 1 or 3 cm.
N Engl J Med, 318 (1988), pp. 1159-1162
[61.]
U. Veronesi, N. Cascinelli.
Narrow excision (1-cm margin). A safe procedure for thin cutaneous melanoma.
Arch Surg, 126 (1991), pp. 438-441
[62.]
C.M. Balch, M.M. Urist, C.P. Karakousis, T.J. Smith, W.J. Temple, K. Drzewiecki, et al.
Efficacy of 2-cm surgical margins for intermediate-thickness melanomas (1 to 4mm). Results of a multi-institutional randomized surgical trial.
Ann Surg, 218 (1993), pp. 262-269
[63.]
K.M. Heaton, J.J. Sussman, J.E. Gershenwald, J.E. Lee, D.S. Reintgen, P.F. Mansfield, et al.
Surgical margins and prognostic factors in patients with thick (>4 mm) primary melanoma.
Ann Surg Oncol, 5 (1998), pp. 322-328
[64.]
G. Cohn-Cedermark, L.E. Rutqvist, R. Andersson, M. Breivald, C. Ingvar, H. Johansson, et al.
Long term results of a randomized study by the Swedish Melanoma Study Group on 2-cm versus 5-cm resection margins for patients with cutaneous melanoma with a tumor thickness of 0.8-2.0mm.
Cancer, 89 (2000), pp. 1495-1501
[65.]
C.M. Balch, S.J. Soong, T. Smith, M.I. Ross, M.M. Urist, C.P. Karakousis, et al.
Long-term results of a prospective surgical trial comparing 2 cm vs. 4 cm excision margins for 740 patients with 1-4 mm melanomas.
Ann Surg Oncol, 8 (2001), pp. 101-108
[66.]
D. Khayat, O. Rixe, G. Martin, C. Soubrane, M. Banzet, J.A. Bazex, et al.
French Group of Research on Malignant Melanoma. Surgical margins in cutaneous melanoma (2 cm versus 5 cm for lesions measuring less than 2.1 mm thick).
Cancer, 97 (2003), pp. 1941-1946
[67.]
P.I. Haigh, L.A. DiFronzo, D.R. McCready.
Optimal excision margins for primary cutanous melanoma: a systematic review and meta-analysis.
Can J Surg, 46 (2003), pp. 419-426
[68.]
J.M. Thomas, J. Newton-Bishop, R. A’Hern, G. Coombes, M. Timmons, J. Evans, et al.
Excision margins in high-risk malignant melanoma.
N Engl J Med, 350 (2004), pp. 757-766
[69.]
B.J. Mehrara, A.A. Abood, J.J. Disa, A.L. Pusic, E. Halvorson, P.G. Cordeiro, et al.
Thumb reconstruction following resection for malignant tumors.
Plast Reconstr Surg, 121 (2008), pp. 1279-1287
[70.]
J.A. Zitelli, C. Brown, B.H. Hanusa.
Mohs micrographic surgery for the treatment of primary cutaneous melanoma.
J Am Acad Dermatol, 37 (1997), pp. 236-245
[71.]
M.E. Dawn, A.G. Dawn, S.J. Miller.
Mohs surgery for the treatment of melanoma in situ: a review.
Dermatol Surg, 33 (2007), pp. 395-402
[72.]
D.G. Broadland.
The treatment of nail apparatus melanoma with Mohs micrographic surgery.
Dermatol Surg, 27 (2001), pp. 269-273
[73.]
G. Stevens, M.J. McKay.
Dispelling the myths surrounding radiotherapy for treatment of cutaneous melanoma.
Lancet Oncol, 7 (2006), pp. 575-583
[74.]
G. Stevens, A. Hong.
Radiation therapy in the management of cutaneous melanoma.
Surg Oncol Clin N Am, 15 (2006), pp. 353-371
[75.]
L.B. Berk.
Radiation therapy as primary and adjuvant treatment for local and regional melanoma.
Cancer Control, 15 (2008), pp. 233-238
[76.]
C. Conill, S. Jorcano, J. Domingo-Domènech, J. Marruecos, R. Vilella, J. Malvehy, et al.
Toxicity of combined treatment of adjuvant irradiation and interferon alpha2b in high-risk melanoma patients.
Melanoma Res, 17 (2007), pp. 304-309
[77.]
J.M. Kirkwood, M.H. Strawderman, M.S. Ernstoff, Tj. Smith, E.C. Borden, R.H. Blum.
Interferon alfa-2b adjuvant therapy of high-risk resected cutaneous melanoma: the Eastern Cooperative Oncology Group Trial EST 1684.
J Clin Oncol, 14 (1996), pp. 7-17
[78.]
J.J. Grobb, B. Dreno, P. de la Salmoniere, M. Delaunay, D. Cupisol, B. Guillot, et al.
Randomized trial of interferon alpha-2a as adjuvant therapy in resected primary melanoma thicker than 1.5 mm without clinically detectable node metastases. French Cooperative Group on Melanoma.
Lancet, 351 (1998), pp. 1905-1910
[79.]
H. Pehamberger, H. Soyer, A. Steiner, R. Kofler, M. Binder, P. Mischer, et al.
Adjuvant interferon alfa-2a treatment in resected primary stage II cutaneous melanoma. Austrian Malignant Melanoma Cooperative Group.
J Clin Oncol, 16 (1998), pp. 1425-1429
[80.]
J.M. Kirkwood, J.G. Ibrahim, V.K. Sondak, J. Richards, L.E. Flaherty, M.S. Emstoff, et al.
High- and low-dose interferon alfa-2b in high-risk melanoma: first analysis of intergroup trial E1690/S9111/C9190.
J Clin Oncol, 18 (2000), pp. 2444-2458
[81.]
J.M. Kirkwood, J. Ibrahim, D.H. Lawson, M.B. Atkins, S.S. Agarcala, K. Collins, et al.
High-dose interferon alfa-2b does not diminish antibody response to GM2 vaccination in patients with resected melanoma: results of the Multicenter Eastern Cooperative Oncology Group Phase II Trial E2696.
J Clin Oncol, 19 (2001), pp. 1430-1436
[82.]
N. Cascinelli, F. Belli, R.M. MacKie, M. Santinami, R. Bufalino, A. Morabito.
Effect of long term adjuvant therapy with interferon alpha-2a in patients with regional node metastases from cutaneous melanoma: a randomized trial.
[83.]
M.B. Lens, M. Dawes.
Interferon alpha therapy for malignant melanoma: a systematic review of randomized clinical trials.
J Clin Oncol, 20 (2002), pp. 1818-1825
[84.]
B.W. Hancock, K. Wheatley, S. Harris, N. Ives, G. Harrison, J.M. Horsman, et al.
Adjuvant interferon in high-risk melanoma: the AIM HIGH Study--United Kingdom Coordinating Committee on Cancer Research randomized study of adjuvant low-dose extended-duration interferon Alfa-2a in high-risk resected malignant melanoma.
J Clin Oncol, 22 (2004), pp. 53-61
[85.]
J.M. Kirkwood, J. Manola, J. Ibrahim, V. Sondak, M.S. Emstoff, U. Rao, et al.
A pooled analysis of eastern cooperative oncology group and intergroup trials of adjuvant high dose interferon for melanoma.
Clin Cancer Res, 10 (2004), pp. 1670-1677
[86.]
A.M. Eggermont, S. Suciu, R. MacKie, W. Ruka, A. Testori, W. Kruit, et al.
Post-surgery adjuvant therapy with intermediate doses of interferon alfa 2b versus observation in patients with stage IIb/III melanoma (EORTC 18952): randomized controlled trial.
Lancet, 366 (2005), pp. 1189-1196
[87.]
A.M. Eggermont, S. Suciu, M. Santinami, A. Testori, W.H. Kruit, J. Marsden, EORTC Melanoma Group.
Adjuvant therapy with pegylated interferon alfa-2b versus observation alone in resected stage III melanoma: final results of EORTC 18991, a randomised phase III trial.
[88.]
R. Botella-Estrada.
Controversias sobre el interferón en el tratamiento adyuvante del melanoma.
Actas Dermosifiliogr, 95 (2004), pp. 597-605
[89.]
D.G. Blazer, V.K. Sondak, M.S. Sabel.
Surgical therapy of cutaneous melanoma.
Semin Oncol, 34 (2007), pp. 270-280
[90.]
C. Conill, J.M. Gimferrer, J. Marruecos, J. Domingo-Domenech, R. Vilella, M. Catalan, et al.
Clinical outcome after surgical resection of lung metastases from melanoma.
Clin Transl Oncol, 9 (2007), pp. 48-52
[91.]
T.F. Wood, L.A. DiFronzo, D.M. Rose, P.I. Haigh, S.L. Stern, L. Wanek, et al.
Does complete resection of melanoma metastatic to solid intra-abdominal organs improve survival?.
Ann Surg Oncol, 8 (2001), pp. 658-662
[92.]
C. Conill, J. Fernández-Ibiza, J. Malvehy, S. Puig, M. Sánchez, T. Castel.
Temozolomida en pacientes con metástasis cerebrales de melanoma tratados con irradiación holocraneal.
Med Clin (Barc), 122 (2004), pp. 413-415
[93.]
D.J. Grünhagen, J.H. de Wilt, A.N. van Geel, A.M. Eggermont.
Isolated limb perfusion for melanoma patients--a review of its indications and the role of tumour necrosis factor-alpha.
Eur J Surg Oncol, 32 (2006), pp. 371-380
[94.]
H.A. Tawbi, J.M. Kirkwood.
Management of metastatic melanoma.
Semin Oncol, 34 (2007), pp. 532-545
[95.]
I. Quirt, S. Verma, T. Petrella, K. Bak, M. Charette.
Temozolomide for the treatment of metastatic melanoma: a systematic review.
Oncologist, 12 (2007), pp. 1114-1123
[96.]
C. Conill, M. González-Cao, S. Jorcano, S. Puig, J. Malvehy, R. Marti, et al.
Temozolomide as prophylaxis for melanoma brain metastases.
Melanoma Res, 14 (2004), pp. 73-74
[97.]
M.F. Avril, S. Aamdal, J.J. Grob, A. Hauschild, P. Mohr, J.J. Bonerandi, et al.
Fotemustine compared with dacarbazine in patients with disseminated malignant melanoma: a phase III study.
J Clin Oncol, 22 (2004), pp. 1118-1125
[98.]
M.B. Lens, T.G. Eisen.
Systemic chemotherapy in the treatment of malignant melanoma.
Expert Opin Pharmacother, 4 (2003), pp. 2205-2211
[99.]
T. Petrella, I. Quirt, S. Verma, A.E. Haynes, M. Charette, K. Bak, The members of the Melanoma Disease Site Group of Cancer Care Ontario's Program in Evidence-Based Care.
Single-agent interleukin-2 in the treatment of metastatic melanoma.
Curr Oncol, 14 (2007), pp. 21-26
[100.]
S.E. Krown, M.W. Burk, J.M. Kirkwood, D. Kerr, D.L. Morton, H.F. Oettgen.
Human leukocyte (alpha) interferon in metastatic malignant melanoma: the American Cancer Society phase II trial.
Cancer Treat Rep, 68 (1984), pp. 723-726
[101.]
R. Vilella, D. Benítez, J. Mila, A. Vilalta, R. Rull, F. Cuéllar, et al.
Treatment of patients with progressive unresectable metastatic melanoma with a heterologous polyvalent melanoma whole cell vaccine.
Int J Cancer, 106 (2003), pp. 626-631
[102.]
R. Vilella, D. Benítez, J. Mila, M. Lozano, R. Vilana, J. Pomes, et al.
Pilot study of treatment of biochemotherapy-refractory stage IV melanoma patients with autologous dendritic cells pulsed with a heterologous melanoma cell line lysate.
Cancer Immunol Immunother, 53 (2004), pp. 651-658
[103.]
S.S. Legha, S. Ring, O. Eton, A. Bedikian, A.C. Buzaid, C. Plager, et al.
Development of a biochemotherapy regimen with concurrent administration of cisplatin, vinblastine, dacarbazine, interferon alfa, and interleukin-2 for patients with metastatic melanoma.
J Clin Oncol, 16 (1998), pp. 1752-1759
[104.]
M.G. Cao, J. Malvehy, R. Marti, C. Conill, M. Sánchez, M. Martín, et al.
Biochemotherapy with temozolomide, cisplatin, vinblastine, subcutaneous interleukin-2 and interferon-alpha in patients with metastatic melanoma.
[105.]
O. Eton, S.S. Legha, A.Y. Bedikian, J.J. Lee, A.C. Buzaid, C. Hodges, et al.
Sequential biochemotherapy versus chemotherapy for metastatic melanoma: results from a phase III randomized trial.
J Clin Oncol, 20 (2002), pp. 2045-2052
[106.]
L. Jost, ESMO Guidelines Working group.
Cutaneous malignant melanoma: ESMO clinical recommendations for diagnosis, treatment and follow-up.
Ann Oncol, 18 (2007), pp. ii71-ii73
[107.]
L. Machet, F. Nemeth-Normand, B. Giraudeau, A. Perrinaud, J. Tiguemounine, J. Ayoub, et al.
Is ultrasound lymph node examination superior to clinical examination in melanoma follow-up? A monocentre cohort study of 373 patients.
Br J Dermatol, 15 (2005), pp. 66-70
[108.]
K. Moore Dalal, Q. Zhou, K.S. Panageas, M.S. Brady, D.P. Jaques, D.G. Coit.
Methods of detection of first recurrence in patients with stage I/II primary cutaneous melanoma after sentinel lymph node biopsy.
Ann Surg Oncol, 15 (2008), pp. 2206-2214
[109.]
J. Einwachter-Thompson, R.M. Mackie.
An evidence base for reconsidering current follow-up guidelines for patients with cutaneous melanoma less than 0.5 mm thick at diagnosis.
Br J Dermatol, 159 (2008), pp. 337-341
[110.]
J.M. Auge, R. Molina, E. Filella, E. Bosch, M. González Cao, S. Puig, et al.
S-100b and MIA in Advanced Melanoma in relation to prognostic factors.
Anticancer Research, 25 (2005), pp. 1779-1782
[111.]
J. Domingo-Domènech, T. Castel, J.M. Auge, X.A. García-Albeniz, C. Conill, S. Puig, et al.
Prognostic implications of protein S-100 beta serum levels in the clinical outcome of high-risk melanoma patients.
Tumour Biol, 28 (2007), pp. 264-272
[112.]
M.G. Cao, J.M. Auge, R. Molina, R. Martí, C. Carrera, T. Castel, et al.
Melanoma inhibiting activity protein (MIA), beta-2 microglobulin and lactate dehydrogenase (LDH) in metastatic melanoma.
Anticancer Res, 27 (2007), pp. 595-599
[113.]
A.E. Chang, L.H. Karnell, H.R. Menck.
The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society.
Cancer, 83 (1998), pp. 1664-1678
[114.]
K.A. Katz, E. Jonasch, F.S. Hodi, R. Soiffer, K. Kwitkiwski, A.J. Sober, et al.
Melanoma of unknown primary: experience at Massachusetts General Hospital and Dana-Farber Cancer Institute.
Melanoma Res, 15 (2005), pp. 77-82
[115.]
G. Vijuk, A.S. Coates.
Survival of patients with visceral metastatic melanoma from an occult primary lesion: a retrospective matched cohort study.
Ann Oncol, 9 (1998), pp. 419-422
[116.]
N. Pavlidis, E. Briasoulis, J. Hainsworth, F.A. Greco.
Diagnostic and therapeutic management of cancer of an unknown primary.
Eur J Cancer, 39 (2003), pp. 1990-2005
[117.]
F. Henry, C. Piérard-Franchimont, J.E. Arrese, N. Claessens, P. Paquet, G.E. Piérard, Groupe Mosan d’Etude des Tumeurs Pigmentaires.
How I explore… an orphan metastasis from melanoma.
Rev Med Liege, 57 (2002), pp. 405-407
[118.]
B. Schlagenhauff, W. Stroebel, U. Ellwanger, F. Meier, C. Zimmermann, H. Breuninger, et al.
Metastatic melanoma of unknown primary origin shows prognostic similarities to regional metastatic melanoma: recommendations for initial staging examinations.
Cancer, 80 (1997), pp. 60-65
[119.]
A. Vélez, D. Walsh, C.P. Karakousis.
Treatment of unknown primary melanoma.
Cancer, 68 (1991), pp. 2579-2581
Copyright © 2010. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
Download PDF
Idiomas
Actas Dermo-Sifiliográficas
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?