Surgical management of melanoma

Traditionally, melanoma has been considered by surgeons to be a highly lethal malignancy, always requiring a radical surgical approach for optimal chance of cure. Yet melanoma patients who are now being referred for treatment frequently have small early lesions, and surgeons should develop a flexible attitude about management, limiting the size of their excisions and deferring node dissections in many early cases. An aggressive, radical approach remains appropriate for large lesions, progressively enlarging nodes and locally recurrent but not disseminated disease.