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THE MULTIDISCIPLINARY MELANOMA CENTER - 11/09/11

Doi : 10.1016/S0039-6109(05)70525-9 
Richard W. Sagebiel, MD *

Riassunto

The concept of a diverse group of specialists concentrating their efforts on the study of the nature and therapy of malignant melanoma began with Wallace H. Clark, Jr, MD, at the Massachusetts General Hospital in the mid-1960s. He developed what turned out to be the first multidisciplinary melanoma clinic on October 1, 1965, with a prospectively entered, computerized database of clinical and histopathologic attributes. He remembers not only the date but also the name and specific lesion of the first patient (Wallace H. Clark, Jr, MD, personal communication, 1996). Multidisciplinary melanoma centers evolved through a Clinical Cooperative Group involving the Massachusetts General Hospital, New York University, the University of Pennsylvania, and the University of California at San Francisco (UCSF) in the Spring of 1971. Although their formal association lasted only a few years, all of these centers continue now in their studies and treatment of patients with melanoma. Other centers have been started on the model of the original Clark Pigmented Lesion Clinic, and now many melanoma clinics have databases exceeding 5000 patients each.

The UCSF Melanoma Center began on March 3, 1971 with Dr. M. Scott Blois as director, dermatologist, and computer scientist. The idea of the multidisciplinary clinic was developed because the patient with melanoma in the 1960s and early 1970s had no care center to coordinate the process from initial biopsy, re-excision with (not uncommonly) lymph node dissection, and subsequent follow-up. Patients were falling through the cracks of medical care without any real understanding of their cancer or its management. At that time the UCSF Clinic consisted of two dermatologists (Dr. Blois and Dr. William Epstein), an immunologist (Dr. Lynn Spitler), and myself as pathologist. The advantages of a multidisciplinary approach to the care of melanoma patients were quickly recognized, and the help of a surgical oncologist, Dr. Robert E. Allen, Jr., was elicited. Dr. Allen continues to attend the UCSF Melanoma Clinic. Since the initial clinic, I have reviewed all of the pathology material on the patients in the melanoma database, which now exceeds 5000.

The current clinic specialists include the following:

Pathology and Clinic Director: R. W. Sagebiel
Medical Oncology, Dermatology, and Assistant Director: Mohammed Kashani-Sabet
Surgical Oncology: Stanley P. L. Leong, Robert E. Allen, Jr.
Medical Oncology: Alan Glassberg, Ernest Rosenbaum, Edwin M. Jacobs
Radiation Oncology: Stanley Meyler
Plastic Surgery: Issa Eshima
ENT Surgery: Steven Sloan
Dermatologic Surgery: Marie-Josef Thiebault
Melanoma Fellow: Serena Mraz
Dermatology: William Epstein
Clinical Psychology: Andrew W. Kneier

The advantages of a multidisciplinary clinic for a specific disease include the following:

Il testo completo di questo articolo è disponibile in PDF.

Mappa


 Address reprint requests to Richard W. Sagebiel, MD, UCSF/Mount Zion Melanoma Center, 2356 Sutter Street, 4th floor, San Francisco, CA 94115


© 1996  W. B. Saunders Company. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 76 - N° 6

P. 1433-1439 - dicembre 1996 Ritorno al numero
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  • STAGING EVALUATION AND SURVEILLANCE FOR MELANOMA PATIENTS IN A FISCALLY RESTRICTIVE MEDICAL ENVIRONMENT : A Commentary
  • Merrick I. Ross

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