Melanoma surgical therapy

Stage 0: excision with a margin of normal-appearing skin of 0.5 cm

Stage  I: the excision depends upon the melanoma:

• <1 mm: margin of 1 cm of normal-appearing skin
• 1 to 2 mm: margin of 2 cm of normal-appearing skin, sentinel lymph node biopsy is recommended if the melanoma is in stage IB.

Stage II: for tumors from 2 to 3 millimeter  margin of  3 cm of normal-appearing skin sentinel lymph node biopsy is recommended. If the tumor is thicker than 4 milimeter or if the lymph node biopsy is positive medical therapy is advised

Stage III: From 3 to 4 mm excision with wide margin at least 3 cm, regional lymph node dissection and medical therapy. For melanomas of the limbs a therapeutic option may be the limb perfusion. If many  lymph nodes are positive we can do postsurgical x-ray. All the other medical treatments (immunotherapy, citochins etc) can be executed.

Stage IV: treatment has yet been shown to prolong survival or cure disease in Stage IV melanoma. The primary melanoma is excised with wide margin metastasis or melanoma satellitosis must be removed and the regional lymph nodes removed. Medical or radiation therapy is given.

Lentigo malignant melanoma: the tumor margins are identified by dermoscopy or Wood lamp. Mohs surgery is a good therapeutical option

Website by Dott Nicola Angelotti, Dermatologist, Massa, Italy, Email: dermatologo@virgilio.it

melanoma surgery