Tatalaksana Melanoma Maligna Kutaneus
DOI:
https://doi.org/10.55175/cdk.v48i7.94Kata Kunci:
Melanoma kutaneus, tatalaksanaAbstrak
Melanoma merupakan suatu tumor maligna dari melanosit, dengan lokasi paling sering adalah kulit (95% kasus). Tatalaksana melanoma tergantung stadium saat diagnosis; dengan pembedahan masih merupakan pilihan utama. Pengobatan melanoma primer adalah bedah eksisi definitif dengan batas eksisi berdasarkan ketebalan tumor. Pada keterlibatan nodus limfatikus regional, dapat dilakukan diseksi elektif komplit. Pada rekurensi lokal dilakukan bedah reseksi komplit dengan penutupan luka primer atau eksisi lokal luas disertai skin grafting ataupun penutupan flap. Metastasis melanoma dibedakan menjadi metastasis kulit atau jauh. Tatalaksana metastasis melanoma dapat berupa terapi sistemik (targeted therapy, terapi imun, dan kemoterapi) dan/atau radiasi. Terapi adjuvan diberikan hanya untuk pasien tanpa bukti metastasis tetapi berisiko tinggi penyebaran tumor lebih lanjut.
Melanoma is a malignant tumor of melanocytes, the most frequent location is in the skin (95% cases). Management of melanoma depends on the stage at diagnosis. Surgery is still the main choice of therapy. Treatment of primary melanoma is definitive excision surgery with excision limit based on the thickness of the tumor. In regional lymph node involvement, complete elective dissection can be performed. In local recurrence, complete resection is performed with primary wound closure or extensive local excision with skin grafting or flap closure. Treatment of melanoma metastasis can be divided into skin metastases or distant. Management of melanoma metastases can be systemic therapy (targeted therapy, immune therapy, and chemotherapy) and radiation. Adjuvant therapy is only given to patients without evidence of metastasis but is at high risk for further spread of the tumor.
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Referensi
McCourt C, Dolan O, Gormley G. Malignant melanoma: A pictorial review. Ulster Med J. 2014;83(2):103-10.
Rutkowski P, Zdzienicki M, Nowecki ZI, Van Akkooi AC. Surgery of primary melanomas. Cancers (Basel) 2010;2(2):824-41.
Eggermont AMM, Spatz A, Robert C. Cutaneous melanoma. Lancet 2014;383:816–27.
Levine SM, Shapiro RL. Surgical treatment of malignant melanoma-practical guidelines. Dermatol Clin. 2012;30:487–501.
Tan ST, Dewi IP. Melanoma maligna. CDK. 2015;42(12): 908-13.
Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A, et al. Melanoma clinical practice guidelines in oncology. JNCCN. 2012;10(3):366-400.
Garbe C, Peris K, Hauschild A, Saiag P, Middleton M, Spatz A, et al. Diagnosis and treatment of melanoma. European consensus-based interdisciplinary guideline-Update 2012. Eur J Cancer 2012;48:2375–90.
Pflgfelder A, Kochs C, Blum A, Capellaro M, Czeschik C, Dettenborn T, et al. Malignant melanoma S3-guideline: Diagnosis, therapy and follow-up of melanoma. JDDG. 2013;11(6):1-116.
Chang JWC. Cutaneous melanoma: Taiwan experience and literature review. Chang Gung Med J. 2010;33(6):602-11.
Coit DG, Thompson JA, Albertini MR, Barker C, Carson WE, Contreras C, et al. Cutaneous melanoma, Version 2.2019. JNCCN. 2019; 17(4):367-402.
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