Diagnosis and management of early melanoma: a consensus view

The inefficacy of treatments for advanced melanoma have shifted the focus toward the recognition of early melanoma which is associated with a much more favorable outcome. In January 1992 the National Institutes of Health (NIH) held a Consensus Conference to establish definitions and therapeutic recommendations for the management of early melanoma. Early melanoma was defined as either in situ or invasive melanoma < 1 mm in depth. Surgical margins of 0.5 cm for in situ melanoma and 1 cm for invasive melanoma < or = 1 mm thick were recommended. The pathology reports should include as a minimum the diagnosis of melanoma, the maximum tumor thickness, and the status of the margins. Elective nodal dissection as well as high-tech radiologic procedures were not recommended. Follow-up of patients for the development of second primaries and of family members who may be at increased risk for melanoma was also recommended. Public education programs were suggested to inform the public of the increasing melanoma risk and improved survival through early detection.