Curability of melanoma: a 25-year retrospective study

On the basis of a study of 193 patients with localized melanoma followed for 25 years, it appears that such tumors are curable, in about 75% of the cases, by surgical removal alone. Of the 41 patients who died from this tumor, 92% succumbed during the first decade and the rest during the next five years. There were no deaths due to melanoma after 15 years of observation. Prophylactic lymph node dissection on these localized cases improved the survival statistics, but this may have been due to the elimination from this series of those with microscopic nodal metastases. A hopeless prognosis is unjustified in patients with primary melanoma because approximately only 25% of the patients in this series succumbed to this tumor during the 25 years of observation. Therapy in such individuals should be conservative until the diagnosis has been established by histopathologic examination. This policy minimizes unnecessary multilation and morbidity in benign lesions. The diagnosis should be suspected early and established or eliminated at the earliest possible time.