El tratamiento del melanoma: una perspectiva histórica
DOI:
https://doi.org/10.56050/01205498.1570Palabras clave:
Tratamiento melanoma, cáncer, HistoriaResumen
Considerables avances se han vivido en los últimos años, tanto en el conocimiento de la biología del melanoma como en el desarrollo de nuevas terapias médicas que han acreditado ser muy activas, capaces no sólo de inducir respuestas clínicas y radiológicas, sino también de controlar la enfermedad a largo plazo. Más aún, los resultados actualizados de los ensayos fase 3 randomizado en pacientes con enfermedad avanzada o de alto riesgo, han hecho a muchos investigadores especular sobre la posibilidad de que se haya conseguido incluso curar a algunos pacientes. No se puede obviar que los resultados actuales se han precedido de numerosos años de fracasos en la investigación médica con quimioterapia y bioquimioterapia, de varias décadas de investigación y refinamiento en las técnicas quirúrgicas que demostraron ser curativas para la enfermedad localizada y, literalmente, de centurias de perplejidad, ante una enfermedad desconcertante por su comportamiento y agresividad clínica. Presentamos una breve revisión histórica del conocimiento del melanoma, desde una perspectiva médico quirúrgica, con el objetivo que despertar en el lector el interés por avanzar en el conocimiento del pasado y sobre todo del futuro de una patología tumoral, que hasta hace muy poco no tenía opciones terapéuticas, pero que ha abierto las puertas para la innovación terapéutica en oncología.
Biografía del autor/a
Pablo Cerezuela-Fuentes, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia
Servicio de Oncología Médica, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia.
María González-Cao, Hospital Universitari Dexeus, Barcelona.
Servicio de Oncología Médica Hospital Universitari Dexeus, Barcelona.
Antonio Piñero-Madrona, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia
Servicio de Cirugía, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia.
Sebastián Ortiz-Reina, Complejo Hospitalario de Cartagena
Servicio de Anatomía Patológica, Complejo Hospitalario de Cartagena, Cartagena.
Enrique Espinosa-Arranz, Hospital Universitario La Paz, Madrid
Servicio de Oncología Médica Hospital Universitario La Paz, Madrid.
Eva Muñoz-Couselo, Hospital Universitari Vall d’Hebron, Barcelona
Servicio de Oncología Médica Hospital Universitari Vall d’Hebron, Barcelona.
José Luis Manzano-Mozo, nstitut Catalá d’Oncologia Badalona, Barcelona
Servicio de Oncología Médica Institut Catalá d’Oncologia Badalona, Barcelona.
Iván Márquez-Rodas, Hospital General Universitario Gregorio Marañón & CIBERONC, Madrid
Servicio Oncología Médica Hospital General Universitario Gregorio Marañón & CIBERONC, Madrid
Teresa Puértolas-Hernández, Hospital Universitario Miguel Servet, Zaragoza
Servicio Oncología Médica Hospital Universitario Miguel Servet, Zaragoza
Salvador Martín-Algarra, Clínica Universidad de Navarra, Pamplona
Servicio Oncología Médica Clínica Universidad de Navarra, Pamplona
Ainara Soria-Rivas, Hospital Universitario Ramón y Cajal, Madrid
Servicio de Oncología Médica Hospital Universitario Ramón y Cajal, Madrid.
Alfonso Berrocal-Jaime, Hospital General Universitario de Valencia, Valencia
Servicio de Oncología Médica Hospital General Universitario de Valencia, Valencia
Referencias bibliográficas
1. Lowenstein EJ. Paleodermatoses: Lessons learned from mummies. J Am Acad Dermatol. 2004;50(6):919–36.
2. Urteaga O Pack GT. On the antiquity of melanoma. Cancer. 1966; 19(5):607–10.
3. Karpozilos A, Pavlidis N. The treatment of cancer in Greek antiquity. Eur J Cancer. 2004;40(14):2033–40.
4. Nieweg OE, Uren RF, Thompson JF. The history of sentinel lymph node biopsy. Cancer J . 2015;21(1):3–6.
5. Holme E. Observations on Cancer. W. Bulmer and Co, London; 1805. 48 p.
6. Bodenham DC. A study of 650 observed malignant melanomas in the South-West region. Ann R Coll Surg Engl. 1968;43(4):218–39.
7. Laennec RTH. Sur les melanoses. En: Bull Faculté de Médecine de Paris 1804 (Tome Premier) 1. 1806. p. 24–6.
8. Denkler K, Johnson J. A lost piece of melanoma history. Plast Reconstr Surg. 1999;104((7)):2149–53.
9. Fawdington T. A case of melanosis, with general observations on the pathology of the interesting disease. En: London: Longman, Orme, Brown, Robinson and Bent. 1826.
10. Norris W. Case of Fungoid Disease. Edinb Med Surg J. 1817;16:562–5.
11. Carswell R. Illustrations of the elementary forms of disease. En: London: Longman, Orme, Brown, Greene and Longman. 1838.
12. Cooper S. First lines of the theory and practice of surgery. London: Longman, Orme and Co; 1840.
13. Paget J. Lectures on Surgical Pathology. Longman, Brown, Green and Longman; 1853.
14. Norris W. Eight cases of Melanosis with pathological and therapeutical remarks on that disease.Londres: Longman, Brown, Greene, Longmans, and Roberts; 1857.
15. Hutchinson J. Melanotic disease of the great toe, following a whitlow of the nai. Trans Pathol Soc L. 1857;8:404.
16. Pemberton O. Observations on the history, pathology and treatment of cancerous diseases. J Churchill, Londres; 1858.
17. Virchow RLK. Cellular Pathology. Special Edition. Londres: John Churchill; 1859.
18. Antón A . Inmunología tumoral e inmunoterapia del cáncer. Zaragoza: Amazing Books; 2018.
19. Coley WB. The treatment of malignant tumors by repeated inoculations of erysipelas. With a report of ten original cases. Clin Orthop Relat Res. 1893;(262):3–11.
20. Tennent GP. On a case of multiple melanotic sarcoma. Glas Med J. 1885;24:81–91.
21. Coats J. On a case of multiple melanotic sarcoma. Glas Med J. 1885;24:92–7.
22. Snow H. Melanotic cancerous disease. Lancet. 1892;2:872.
23. Halsted WS. The Results of Operations for the Cure of Cancer of the Breast Performed At the Johns Hopkins Hospital From June, 1889, To January, 1894. Ann Surg. 1894;20:497–555.
24. Gerota D. Zur Technik der Lymphgefassinjection. Eine neue injections Masse für Lymphgefass. Polychrom Inject Anat Anzeiger. 1896;12:216–24.
25. Eve F. A lecture on melanoma. Practicioner. 1903;70:165–74.
26. Handley WS. The pathology of melanotic growths in relation to their operative treatment. Lancet. 1907;1:927–33.
27. Ehrlich P. Ueber den jetzigen stand der Karzinomforschung. Ned Tijdschr Geneeskd. 1909;5:273–90.
28. Morton DL, Eilber FR, Joseph WL et al. Immunological factors in human sarcomas and melanomas: a rational basis for immunotherapy. Ann Surg. 1970;172:740–9.
29. Morgan DA, Ruscetti FW GR. Selective in vitro growth of T lymphocytes from normal human bone marrows. Science (80- ). 1976;193:1007–8.
30. Pratt WB, Ruddon RW EW. The Anticancer Drugs 2nd Edition. New York: Oxford University Press; 1994.
31. Krementz ET,Ryan RF. Chemotherapy of melanoma of the extremities by perfusion: fourteen years clinical experience. Ann Surg. 1972;175:900–17.
32. Livingston RB CS. Single agents in cancer chemotherapy. New York: IFI/Plenum; 1970.
33. Hill II GJ, Ruess R, Berris R et al. Chemotherapy of malignant melanoma with dimethyl traizeno imidazole carboxamide (DITC) and nitrosourea derivatives (BCNU, CCNU). Ann Surg. 1974;180:167–74.
34. Yang AS CP. The history and future of chemotherapy for melanoma. Hematol Oncol Clin North Am. 2009;23(3):583–97.
35. Morton DL, Wen DR, Wong JH et al. Technical details of intraoperative lymphaticmapping for early stage melanoma. Arch Surg. 1992;127:392–9.
36. Clark Jr WH, From L, Bernardino EA et al. histogenesis and biologic behavior of primary human malignant melanomas of the skin. Cancer Res. 1969;29:705–27.
37. Breslow A. Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma. Ann Surg. 1970;902–8.
38. Breslow A. Tumor thickness, level of invasion and node dissection in stage I cutaneous melanoma. Ann Surg. 1975;182(5):572–5.
39. Breslow A MS. Optimal size of resection margin for thin cutaneous melanoma. Surg Gynecol Obs. 1977;145:691–2.
40. Veronesi U, Adamus J, Bandiera DC et al. Delayed regional lymph node dissection in stage I melanoma of the skin of the lower extremities. Cancer. 1982;49:2420–30.
41. Morton DL, Thompson JF, Cochran AJ, Mozzillo N, Elashoff R, Essner R et al. Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med. 2006;28;355(13):1307–17.
42. Azzola MF, Shaw HM, Thompson JF et al. Tumor mitotic rate is a more powerful prognostic indicator than ulceration in patients with primary cutaneous melanoma: an analysis of 3661 patients from a single center. Cancer. 2003;97:1488–98.
43. Sondak VK, Taylor JM SM et al. Mitotic rate and younger age are predictors of sentinel lymph node positivity: lessons learned from the generation of a probabilistic model. Ann Surg Oncol. 2004;11:247–58.
44. McGovern VJ, Cochran AJ van der EE et al. The classification of malignant melanoma, its histological reporting and registration: a revision of the 1972 Sydney classification. Pathology. 1986;1986 Jan;1(1):12–21.
45. Allen AC SS. Malignant melanoma. A clinicopathological analysis of the criteria for diagnosis and prognosis. Cancer. 1953;6:1–45.
46. Kirkwood JM, Strawderman MH, Ernstoff MS et al. Interferon alfa-2b adjuvant therapy of high-risk resected cutaneous melanoma: the Eastern Cooperative Oncology Group Trial EST 1684. J Clin Oncol. 1996;14:7–17.
47. Eggermont AM. The role interferon-alpha in malignant melanoma remains to be defined. Eur J Cancer. 2001;Nov;37(17):2147–53.
48. Rosenberg SA, Lotze MT, Muul LM et al. Observations on the systemic administration of autologous lymphokine-activated killer cells and recombinant interleukin-2 to patients with metastatic cancer. N ENgl J Med. 1985;313:1485–92.
49. Atkins MB, Lotze MT, Dutcher JP et al. High-dose recombinant interleukin 2 therapy for patients with metastatic melanoma: analysis of 270 patients treated between 1985 and 1993. J Clin Oncol. 1999;17:2105–16.
50. Atkins MB, Hsu J LS et al. Eastern Cooperative Oncology Group. Phase III trial comparing concurrent biochemotherapy with cisplatin, vinblastine, dacarbazine, interleukin-2, and interferon alfa-2b with cisplatin, vinblastine, and dacarbazine alone in patients with metastatic maligna. J Clin Oncol. 2008;Dec 10;26(35):5748–54.
51. Agarwala SS, Glaspy J, O’Day SJ et al. Results from a randomized phase III study comparing combined treatment with histamine dihydrochloride plus interleukin-2 versus interleukin-2 alone in patients with metastatic melanoma. J Clin Oncol. 2002;20:125–33.
52. Morgan RA, Dudley ME, Wunderlich JR et al. Cancer regression in patients after transfer of genetically engineered lymphocytes. Science (80- ). 2006;314:126–9.
53. Rous P. A Sarcoma of the Fowl Transmissible by an Agent Separable from the Tumor Cells. J Exp Med. 1911;13:397–411.
54. Malumbres M BM. RAS oncogenes: the first 30 years. Nat Rev Cancer. 2003;3:459–65.
55. Davies H, Bignell GR, Cox C, Stephens P, Edkins S, Clegg S et al. Mutations of the BRAF gene in human cancer. Nature. 2002;417(6892):949–54.
56. Toussi A, Mans N, Welborn J, Kiuru M. Germline mutations predisposing to melanoma. J Cutan Pathol. 2020;Jul;47(7):606–16.
57. Chapman PB, Hauschild A, Robert C, Haanen PA, larkin J, Dummer R et al. Improved survival with vemurafenib in melanoma with BRAF V600E mutation. N Engl J Med. 2011;30;364(26):2507–16.
58. Sun J, Carr MJ KN. Principles of Targeted Therapy for Melanoma. Surg Clin North Am. 2020;100(1):175–88.
59. Robert C, Thomas L BI et al. Ipilimumab plus dacarbazine for previously untreated metastatic melanoma. N Engl J Med. 2011;30;364(26):2517–26.
60. Pardoll DM. The blockade of immune checkpoints in cancer immunotherapy. Nat Rev Cancer. 2012;12(4):252–64.
61. Onitilo AA WJ. Principles of Immunotherapy in Melanoma. Surg Clin North Am. 2020;100(1):161–73.
62. Press release: The Nobel Prize in Physiology or Medicine 2018 [Internet]. [Consultado 26 de octubre 2020].Disponible en:
https://www.nobelprize.org/prizes/medicine/2018/press-release/
63. Herrscher H RC. Immune checkpoint inhibitors in melanoma in the metastatic, neoadjuvant, and adjuvant setting. Curr Opin Oncol. 2020;32(2):106–13.
64. Hodi FS, Chiarion-Sileni V GR et al. Nivolumab plus ipilimumab or nivolumab alone versus ipilimumab alone in advanced melanoma (CheckMate 067): 4-year outcomes of a multicentre, randomised, phase 3 trial. Lancet Oncol. 2018;19(1):1480–92.
65. Cohen MH, Jessup JM FE et al. Intralesional treatment of recurrent metastatic cutaneous malignant melanoma: a randomized prospective study of intralesional Bacillus Calmette-Guerin versus intralesional dinitrochlorobenzene. Cancer. 1978;41(6):2456–63.
2. Urteaga O Pack GT. On the antiquity of melanoma. Cancer. 1966; 19(5):607–10.
3. Karpozilos A, Pavlidis N. The treatment of cancer in Greek antiquity. Eur J Cancer. 2004;40(14):2033–40.
4. Nieweg OE, Uren RF, Thompson JF. The history of sentinel lymph node biopsy. Cancer J . 2015;21(1):3–6.
5. Holme E. Observations on Cancer. W. Bulmer and Co, London; 1805. 48 p.
6. Bodenham DC. A study of 650 observed malignant melanomas in the South-West region. Ann R Coll Surg Engl. 1968;43(4):218–39.
7. Laennec RTH. Sur les melanoses. En: Bull Faculté de Médecine de Paris 1804 (Tome Premier) 1. 1806. p. 24–6.
8. Denkler K, Johnson J. A lost piece of melanoma history. Plast Reconstr Surg. 1999;104((7)):2149–53.
9. Fawdington T. A case of melanosis, with general observations on the pathology of the interesting disease. En: London: Longman, Orme, Brown, Robinson and Bent. 1826.
10. Norris W. Case of Fungoid Disease. Edinb Med Surg J. 1817;16:562–5.
11. Carswell R. Illustrations of the elementary forms of disease. En: London: Longman, Orme, Brown, Greene and Longman. 1838.
12. Cooper S. First lines of the theory and practice of surgery. London: Longman, Orme and Co; 1840.
13. Paget J. Lectures on Surgical Pathology. Longman, Brown, Green and Longman; 1853.
14. Norris W. Eight cases of Melanosis with pathological and therapeutical remarks on that disease.Londres: Longman, Brown, Greene, Longmans, and Roberts; 1857.
15. Hutchinson J. Melanotic disease of the great toe, following a whitlow of the nai. Trans Pathol Soc L. 1857;8:404.
16. Pemberton O. Observations on the history, pathology and treatment of cancerous diseases. J Churchill, Londres; 1858.
17. Virchow RLK. Cellular Pathology. Special Edition. Londres: John Churchill; 1859.
18. Antón A . Inmunología tumoral e inmunoterapia del cáncer. Zaragoza: Amazing Books; 2018.
19. Coley WB. The treatment of malignant tumors by repeated inoculations of erysipelas. With a report of ten original cases. Clin Orthop Relat Res. 1893;(262):3–11.
20. Tennent GP. On a case of multiple melanotic sarcoma. Glas Med J. 1885;24:81–91.
21. Coats J. On a case of multiple melanotic sarcoma. Glas Med J. 1885;24:92–7.
22. Snow H. Melanotic cancerous disease. Lancet. 1892;2:872.
23. Halsted WS. The Results of Operations for the Cure of Cancer of the Breast Performed At the Johns Hopkins Hospital From June, 1889, To January, 1894. Ann Surg. 1894;20:497–555.
24. Gerota D. Zur Technik der Lymphgefassinjection. Eine neue injections Masse für Lymphgefass. Polychrom Inject Anat Anzeiger. 1896;12:216–24.
25. Eve F. A lecture on melanoma. Practicioner. 1903;70:165–74.
26. Handley WS. The pathology of melanotic growths in relation to their operative treatment. Lancet. 1907;1:927–33.
27. Ehrlich P. Ueber den jetzigen stand der Karzinomforschung. Ned Tijdschr Geneeskd. 1909;5:273–90.
28. Morton DL, Eilber FR, Joseph WL et al. Immunological factors in human sarcomas and melanomas: a rational basis for immunotherapy. Ann Surg. 1970;172:740–9.
29. Morgan DA, Ruscetti FW GR. Selective in vitro growth of T lymphocytes from normal human bone marrows. Science (80- ). 1976;193:1007–8.
30. Pratt WB, Ruddon RW EW. The Anticancer Drugs 2nd Edition. New York: Oxford University Press; 1994.
31. Krementz ET,Ryan RF. Chemotherapy of melanoma of the extremities by perfusion: fourteen years clinical experience. Ann Surg. 1972;175:900–17.
32. Livingston RB CS. Single agents in cancer chemotherapy. New York: IFI/Plenum; 1970.
33. Hill II GJ, Ruess R, Berris R et al. Chemotherapy of malignant melanoma with dimethyl traizeno imidazole carboxamide (DITC) and nitrosourea derivatives (BCNU, CCNU). Ann Surg. 1974;180:167–74.
34. Yang AS CP. The history and future of chemotherapy for melanoma. Hematol Oncol Clin North Am. 2009;23(3):583–97.
35. Morton DL, Wen DR, Wong JH et al. Technical details of intraoperative lymphaticmapping for early stage melanoma. Arch Surg. 1992;127:392–9.
36. Clark Jr WH, From L, Bernardino EA et al. histogenesis and biologic behavior of primary human malignant melanomas of the skin. Cancer Res. 1969;29:705–27.
37. Breslow A. Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma. Ann Surg. 1970;902–8.
38. Breslow A. Tumor thickness, level of invasion and node dissection in stage I cutaneous melanoma. Ann Surg. 1975;182(5):572–5.
39. Breslow A MS. Optimal size of resection margin for thin cutaneous melanoma. Surg Gynecol Obs. 1977;145:691–2.
40. Veronesi U, Adamus J, Bandiera DC et al. Delayed regional lymph node dissection in stage I melanoma of the skin of the lower extremities. Cancer. 1982;49:2420–30.
41. Morton DL, Thompson JF, Cochran AJ, Mozzillo N, Elashoff R, Essner R et al. Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med. 2006;28;355(13):1307–17.
42. Azzola MF, Shaw HM, Thompson JF et al. Tumor mitotic rate is a more powerful prognostic indicator than ulceration in patients with primary cutaneous melanoma: an analysis of 3661 patients from a single center. Cancer. 2003;97:1488–98.
43. Sondak VK, Taylor JM SM et al. Mitotic rate and younger age are predictors of sentinel lymph node positivity: lessons learned from the generation of a probabilistic model. Ann Surg Oncol. 2004;11:247–58.
44. McGovern VJ, Cochran AJ van der EE et al. The classification of malignant melanoma, its histological reporting and registration: a revision of the 1972 Sydney classification. Pathology. 1986;1986 Jan;1(1):12–21.
45. Allen AC SS. Malignant melanoma. A clinicopathological analysis of the criteria for diagnosis and prognosis. Cancer. 1953;6:1–45.
46. Kirkwood JM, Strawderman MH, Ernstoff MS et al. Interferon alfa-2b adjuvant therapy of high-risk resected cutaneous melanoma: the Eastern Cooperative Oncology Group Trial EST 1684. J Clin Oncol. 1996;14:7–17.
47. Eggermont AM. The role interferon-alpha in malignant melanoma remains to be defined. Eur J Cancer. 2001;Nov;37(17):2147–53.
48. Rosenberg SA, Lotze MT, Muul LM et al. Observations on the systemic administration of autologous lymphokine-activated killer cells and recombinant interleukin-2 to patients with metastatic cancer. N ENgl J Med. 1985;313:1485–92.
49. Atkins MB, Lotze MT, Dutcher JP et al. High-dose recombinant interleukin 2 therapy for patients with metastatic melanoma: analysis of 270 patients treated between 1985 and 1993. J Clin Oncol. 1999;17:2105–16.
50. Atkins MB, Hsu J LS et al. Eastern Cooperative Oncology Group. Phase III trial comparing concurrent biochemotherapy with cisplatin, vinblastine, dacarbazine, interleukin-2, and interferon alfa-2b with cisplatin, vinblastine, and dacarbazine alone in patients with metastatic maligna. J Clin Oncol. 2008;Dec 10;26(35):5748–54.
51. Agarwala SS, Glaspy J, O’Day SJ et al. Results from a randomized phase III study comparing combined treatment with histamine dihydrochloride plus interleukin-2 versus interleukin-2 alone in patients with metastatic melanoma. J Clin Oncol. 2002;20:125–33.
52. Morgan RA, Dudley ME, Wunderlich JR et al. Cancer regression in patients after transfer of genetically engineered lymphocytes. Science (80- ). 2006;314:126–9.
53. Rous P. A Sarcoma of the Fowl Transmissible by an Agent Separable from the Tumor Cells. J Exp Med. 1911;13:397–411.
54. Malumbres M BM. RAS oncogenes: the first 30 years. Nat Rev Cancer. 2003;3:459–65.
55. Davies H, Bignell GR, Cox C, Stephens P, Edkins S, Clegg S et al. Mutations of the BRAF gene in human cancer. Nature. 2002;417(6892):949–54.
56. Toussi A, Mans N, Welborn J, Kiuru M. Germline mutations predisposing to melanoma. J Cutan Pathol. 2020;Jul;47(7):606–16.
57. Chapman PB, Hauschild A, Robert C, Haanen PA, larkin J, Dummer R et al. Improved survival with vemurafenib in melanoma with BRAF V600E mutation. N Engl J Med. 2011;30;364(26):2507–16.
58. Sun J, Carr MJ KN. Principles of Targeted Therapy for Melanoma. Surg Clin North Am. 2020;100(1):175–88.
59. Robert C, Thomas L BI et al. Ipilimumab plus dacarbazine for previously untreated metastatic melanoma. N Engl J Med. 2011;30;364(26):2517–26.
60. Pardoll DM. The blockade of immune checkpoints in cancer immunotherapy. Nat Rev Cancer. 2012;12(4):252–64.
61. Onitilo AA WJ. Principles of Immunotherapy in Melanoma. Surg Clin North Am. 2020;100(1):161–73.
62. Press release: The Nobel Prize in Physiology or Medicine 2018 [Internet]. [Consultado 26 de octubre 2020].Disponible en:
https://www.nobelprize.org/prizes/medicine/2018/press-release/
63. Herrscher H RC. Immune checkpoint inhibitors in melanoma in the metastatic, neoadjuvant, and adjuvant setting. Curr Opin Oncol. 2020;32(2):106–13.
64. Hodi FS, Chiarion-Sileni V GR et al. Nivolumab plus ipilimumab or nivolumab alone versus ipilimumab alone in advanced melanoma (CheckMate 067): 4-year outcomes of a multicentre, randomised, phase 3 trial. Lancet Oncol. 2018;19(1):1480–92.
65. Cohen MH, Jessup JM FE et al. Intralesional treatment of recurrent metastatic cutaneous malignant melanoma: a randomized prospective study of intralesional Bacillus Calmette-Guerin versus intralesional dinitrochlorobenzene. Cancer. 1978;41(6):2456–63.
Cómo citar
[1]
Cerezuela-Fuentes, P. et al. 2021. El tratamiento del melanoma: una perspectiva histórica. Medicina. 42, 4 (feb. 2021), 707–721. DOI:https://doi.org/10.56050/01205498.1570.
Descargas
Los datos de descargas todavía no están disponibles.
Publicado
2021-02-12
Número
Sección
Perspectiva del diagnóstico y Tratamiento del Cancer
Licencia
Derechos de autor 2021 Medicina
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
Copyright
ANM de Colombia
Los autores deben declarar revisión, validación y aprobación para publicación del manuscrito, además de la cesión de los derechos patrimoniales de publicación, mediante un documento que debe ser enviado antes de la aparición del escrito. Puede solicitar el formato a través del correo revistamedicina@anmdecolombia.org.co o descargarlo directamente Documento Garantías y cesión de derechos.docx
Copyright
ANM de Colombia
Authors must state that they reviewed, validated and approved the manuscript's publication. Moreover, they must sign a model release that should be sent.
