Melanoma surgery
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Serge Korjian M.D.
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Melanoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Melanoma surgery On the Web |
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American Roentgen Ray Society Images of Melanoma surgery |
Overview
Surgery
Surgical Margins for Wide Excision of Primary Melanoma
- The National Comprehensive Cancer Network (NCCN) recommends wide excision of margins of primary tumors based on tumor thickness.[1]
- The margins may be individualized to accomodate anatomic and functional considerations.[1]
| Tumor thickness | Recommended Clinical Margins |
| In situ | 0.5 cm |
| ≤ 1 mm | 1 cm |
| > 1 mm - 2 mm | 1-2 cm |
| > 2 mm - 4 mm | 2 cm |
| > 4 mm | 2 cm |
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Complete Lymph Node Dissection
The 2013 National Comprehensive Cancer Network (NCCN) recommend the following:[1]
- Complete dissection of involved nodal basin is recommended
- Specific considerations for the groin lymp nodes
- Indications for iliac and obturator lymph node dissection:
- Positive pelvic CT, OR
- Cloquet's node is positive
- Elective iliac and obturator lymph node dissection
- Clinically positive superficial node, OR
- ≥ 3 superficial nodes are positive