Current concepts review: management of melanoma

Management of melanoma is still based almost exclusively on the thickness of the primary lesion. Recent studies demonstrated that a surgical margin of 1 cm is adequate for most thin melanomas (1 mm or less in Breslow thickness), whereas thicker lesions may be removed with a surgical margin of 2 to 3 cm without adversely affecting the rate of local recurrence or patient survival. The value of prophylactic lymph node dissection in the management of primary melanoma is still debated. The role of chemotherapy and immunologic modalities in the treatment of this type of neoplasm requires better understanding and awaits the results of randomized, prospective studies.