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Surgery of Primary Melanomas
Soft Tissue/Bone Sarcoma and Melanoma Department, M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
Erasmus University Medical Center–Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
* Author to whom correspondence should be addressed.
Received: 29 March 2010; in revised form: 2 May 2010 / Accepted: 5 May 2010 / Published: 11 May 2010
Abstract: Surgery remains the mainstay of melanoma therapy, regardless of the tumor site. Only the early diagnosis combined with proper surgical therapy currently gives patients affected by this malignancy the chance for a full cure. The main goal of surgical therapy is to provide the local control of the disease and to secure long-term survival of the patient without reasonable functional and esthetic impairment. The recommended method of biopsy—excisional biopsy, as an initial diagnostic and, to some extent, therapeutic procedure—is performed under local anesthesia as an elliptical incision with visual clear margins of 1–3 mm and with some mm of subcutaneous tissue. The extent of radical excision of the primary tumor (or scar after excisional biopsy) is based on the histopathologic characteristics of the primary tumor and usually consists of 1–2 cm margins with primary closure. The philosophy behind conducted randomized clinical trials has been to find the most conservative surgical approach that is able to guarantee the same results as more demolitive treatment. This has been the background of the trials designed to define the correct margins of excision around a primary cutaneous melanoma. Much less definition can be dedicated to the surgical management of patients with non-cutaneous melanomas.
Keywords: cutaneous melanoma; melanoma treatment; surgery; wide excision
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Rutkowski, P.; Zdzienicki, M.; Nowecki, Z.I.; Van Akkooi, A.C.J. Surgery of Primary Melanomas. Cancers 2010, 2, 824-841.
Rutkowski P, Zdzienicki M, Nowecki ZI, Van Akkooi ACJ. Surgery of Primary Melanomas. Cancers. 2010; 2(2):824-841.
Rutkowski, Piotr; Zdzienicki, Marcin; Nowecki, Zbigniew I.; Van Akkooi, Alexander C. J. 2010. "Surgery of Primary Melanomas." Cancers 2, no. 2: 824-841.