[Value of surgery for malignant melanoma in the context of current adjuvant and neoadjuvant treatment concepts]

The field of melanoma treatment is also dynamic with respect to surgical procedures. In the treatment of the primary tumor the safety margins have been reduced based on study data. In surgery of the regional lymph nodes elective lymph node dissection has been discontinued in favor of sentinel lymph node (SLN) extirpation. Whether SLN extirpation can even be dispensed with in view of adjuvant treatment, particularly in patients with thicker primary tumors, needs to be further investigated. In the stage of regional macrometastasis, neoadjuvant or perioperative drug treatment should be considered before surgical measures. In the case of distant metastasis and disseminated disease, systemic treatment is also the first choice and in the case of local complications or oligoprogression under systemic treatment, surgical measures can also be considered.