Surgical Management of Melanoma

ABSTRACT

This chapter discusses the surgical principles in the management of melanoma. Surgery remains the mainstay of treatment of primary melanoma, and in the majority of cases it is curative. Appropriate surgical management is critical for the diagnosis, staging, and optimal treatment of both in situ and invasive primary cutaneous melanoma. Surgical management is dependent on the stage of the disease, and therefore this chapter evaluates localized, regional, and metastatic disease. The concept of sentinel lymph node biopsy is discussed along with its benefits, pitfalls, and prognostic significance. Furthermore, sev­eral important surgical issues are discussed, including the extent of surgical margins, Mohs micrographic surgery for melanoma in situ, and the role of metastasectomy.