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Primary Cutaneous Melanoma-Management in 2024.
Anthony Joseph Dixon1,2, Michael Sladden3, Christos C Zouboulis4
1Department of Research, Australasian College of Cutaneous Oncology, Docklands, VIC 3008, Australia.
Journal of Clinical Medicine
|March 28, 2024
Summary
Early diagnosis and optimal management are crucial for melanoma survival. Recent research highlights improved treatments and risk assessment, emphasizing biopsy techniques and adjuvant drug therapy for better patient outcomes.
Area of Science:
- Dermatology and Oncology
- Cutaneous Malignancies
- Melanoma Management
Background:
- Maximizing survival in primary cutaneous melanoma patients hinges on early diagnosis and appropriate management.
- While guidelines exist, optimal patient care, especially for older individuals, is often not achieved.
- Emerging therapies demonstrate improved survival rates for high-risk melanoma patients.
Purpose of the Study:
- To provide an updated overview of melanoma management strategies.
- To cover the continuum of care from suspicious lesion biopsy to post-treatment surveillance.
- To integrate recent research findings into current clinical practice.
Main Methods:
- Systematic review of melanoma management research published between 2018 and 2023.
- Searches conducted across major scientific databases: PubMed, Google Scholar, Ovid, and Cochrane Library.
- Identification of publications impacting and updating the management of confirmed melanomas.
Main Results:
- 81 publications since 2017 have significantly altered melanoma management protocols.
- Breslow thickness, patient age, and ulceration are key prognostic indicators.
- The BAUSSS biomarker (Breslow thickness, Age, Ulceration, Subtype, Sex, Site) offers improved mortality risk prediction over traditional methods like sentinel lymph node biopsy.
Conclusions:
- Local excision with a narrow margin is preferred for suspected melanoma biopsy over shave or punch biopsies.
- Adjuvant drug therapy (ADT) is increasingly recommended for metastatic, nodal disease, and high-risk melanoma patients.
- Lifelong skin surveillance, total body photography for high-risk individuals, UV exposure management, and vitamin D supplementation are vital components of ongoing melanoma care.
