EVEN if they have the same name, not all tumors are the same: their molecular characteristics make the difference. This also applies to melanoma, the most aggressive skin cancer, the incidence of which is increasing in Italy. It is important to diagnose it early, but also in the correct way, taking into account the mutations that can modify the path of treatment and the choice of drugs. Precisely for this reason, from today, for its diagnosis, there are new guidelines: the specialists of the Italian Society of Pathological Anatomy and Diagnostic Cytology (SIAPEC-IAP Italian Division) drafted them, in collaboration with the Italian Association of Oncology Medica (Aiom) and with the fundamental participation of representatives of patient associations. “The high epidemiological impact of melanoma in the Italian population and the recent introduction of innovative therapies that have radically changed the potential for treatment have led us to consider this new Guideline on ‘Histopathological and molecular diagnosis of melanocytic lesions’ a priority”, he explains. Anna Sabinopresident of SIAPEC-IAP: “The guidelines are based on biomedical literature and are aimed at guiding the clinical practice of pathologists throughout the country with a view to appropriateness”.
The new guidelines
The mandate was given by Mauro Truini, past president of the scientific society, and a multidisciplinary and multiprofessional working group collaborated on the drafting, with anatomical-pathologists, oncologists, dermatologists, surgeons, immunologists, biomedical laboratory technicians, as well as, as mentioned, of patients. The new indications have passed the evaluation process by the National Center for Clinical Excellence, Quality and Safety of Care (CNEC) of the Istituto Superiore di Sanità, which recommended their use (they are in fact published on the website of the ‘ISS, within the National Guidelines System).
A “precise” and reliable report for all patients
“The goal was to standardize and make the structured histopathological report of melanoma more reproducible, in the light of the evidence of the international literature”, underlines Daniela Massi, coordinator of the Guidelines: “We also wanted to clearly illustrate which immunohistochemical and molecular tests are useful to be performed on melanoma tissues in order to refer patients to targeted therapies”. The new document will therefore be decision-making support to determine which of several alternative options is the best. “The ultimate goal – concludes Massi – is to offer patients, in a homogeneous way throughout the country, the most complete and accurate diagnosis and therefore the best personalized therapy.