About 20% of all primary melanomas will spread. The likelihood of metastatic behavior correlates with prognostic factors such as tumor thickness, mitotic index, presence of ulceration, lymphocyte infiltration, age, gender, and anatomic site. Immunotherapies are developed for melanoma patients in stage IV who have distant metastases and in stage II to III patients in the adjuvant micrometastatic setting, where only a fraction of patients have widespread (microscopic) disease.

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doi.org/10.1016/j.hoc.2009.03.009, hdl.handle.net/1765/16295
Hematology / Oncology Clinics of North America
Erasmus MC: University Medical Center Rotterdam

Eggermont, A., & Schadendorf, D. (2009). Melanoma and Immunotherapy. Hematology / Oncology Clinics of North America (Vol. 23, pp. 547–564). doi:10.1016/j.hoc.2009.03.009