Current management of vulvar melanoma

In the past, minimal recommended therapy for vulvar melanoma was radical vulvectomy with bilateral inguinal-femoral lymphadenectomy, regardless of lesion size, thickness, or depth of invasion. In the last decade, several authors and investigators have questioned the need for radical surgery in all patients and have used a variety of microstaging methods to delineate risk categories for patients with vulvar melanoma. The author discusses non-vulvar cutaneous melanoma as well as vulvar melanoma, and summarizes the current recommendations for management of the latter.