[Surgical therapy of malignant melanoma of the skin]

Operative treatment is the therapy of choice in malignant melanoma under curative as well as palliative considerations. Today more conservative surgical strategies are preferred, however. Thus, the safety margins for the excision of the primary tumor have been significantly reduced. With the introduction of the minimally invasive sentinel node biopsy the elective lymph node dissection, a high morbidity intervention, has become obsolete. Sentinel node biopsy should be performed in all melanomas thicker than 0.75 mm, as the percentage of lymph nodes harvesting micrometastases increases in correspondence to the clinical tumor stage up to 75%.