By Schmoll Hans-Joachim, Hans-Joachim Schmoll, Laura Van't Meer, Jan Vermorken, Dirk Schrijvers
The staging of melanoma and the choice and assessment of melanoma therapy are the most important subject matters for scientific oncologists, who have to pass judgement on a few of the prognostic and predictive components for every melanoma sort, the relevance of staging, and the dimension of sufferer reaction. a world collection of specialists has right here summarized what each practising clinical oncologist must understand.
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Semin Oncol 1991; 18: 99–110. Van Poppel H, Ameye F, Oyen R, van de Voorde W, Baert L. Accuracy of combined computerized tomography and fine needle aspiration in lymph node staging of localized prostatic carcinoma. J Urol 1994; 151: 1310–4. Wallace MB, Nietert PJ, Earle C, et al. An analysis of multiple staging management strategies for carcinoma of the esophagus: computed tomography, endoscopic ultrasound, positron emission tomography, and thoracoscopy/laparoscopy. Ann Thorac Surg 2002; 74: 1026–32.
In the instance of a positive bone scan, plain radiographs of the hot spots should be made. In case of doubt, a CT or MRI scan may provide further clarity. Bladder cancer Cystoscopy allows the urologist to estimate the intravesical extent of the tumor or tumors and to obtain histology. Intravenous pyelography is gradually being replaced by CT scanning. In the majority of patients, an abdominal CT scan or MRI can provide reliable information on the extent of extravesical tumor spread. It is customary to perform a chest X ray prior 43 to operation.
Data are insufficient to recommend measurement of Ki67, cyclin D, cyclin E, p27, p21, thymidine kinase, topoisomerase II, or other markers of proliferation to assign patients to prognostic groups. ■ The use of HER2 for determining prognosis is not recommended. However, HER2 expression and/or amplification should be evaluated in every primary invasive breast cancer either at the time of diagnosis or at the time of recurrence, principally to guide selection of trastuzumab in the adjuvant and/ or metastatic setting.