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Rare skin tumor responds better to treatment than melanoma
Date:2/2/2009

lar to malignant melanoma by surgically removing the lesion and in many cases also with a sentinel lymph node biopsy. The sentinel lymph node biopsy involves the removal and evaluation of one or a few lymph nodes nearest the skin lesion to determine whether the skin lesion has spread to the lymph nodes.

Ludgate and his team analyzed U-M's unique comprehensive melanoma database that has been collecting data for almost two decades for all cases of ASTs of uncertain biological potential between 1994 and 2007. Data were examined to learn the clinical features of a patient, whether the patient underwent a lymph node biopsy and the histological features of the tumor.

Of the 67 patients in the study, 57 had undergone wide excision and sentinel lymph node biopsy, and 27 biopsies were positive.

All 27 of AST patients with positive sentinel node biopsy are alive and disease-free at an average of about 44 months follow-up, researchers note.

"If AST were a form of melanoma, we would expect that at least some of the patients would have had the AST recur throughout the body by this time" Ludgate explains. "This study provides evidence that although ASTs have some features of melanoma microscopically, they do not behave as aggressively."

These findings can be interpreted in three ways, Ludgate says. "The first is that AST is not cancer at all, but has some ability to spread. The second possibility is that because ASTs often occur in younger people with intact immune systems, the body is able to successfully fight off the beginnings of metastatic disease. The third possibility is that AST is potentially deadly but removal of the primary AST lesion and the sentinel lymph node biopsy is curative."

Each of these possibilities is considered in the treatment strategy developed collectively as a result of this study. One result of this new strategy is that not every patient with AST must undergo a complete lymph node dissection or
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Contact: Katie Vloet
kgazella@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

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