Evidence and interdisciplinary consensus-based German guidelines: surgical treatment and radiotherapy of melanoma.

Abstract:

:The primary treatment of a melanoma is surgical excision. An excisional biopsy is preferred, and safety margins of 1 cm for tumor thickness up to 2 mm and 2 cm for higher tumor thickness should be applied either at primary excision or in a two-step procedure. When dealing with facial, acral or anogenital melanomas, micrographic control of the surgical margins may be preferable to allow reduced safety margins and conservation of tissue. The sentinel lymph node biopsy should be performed in patients whose primary melanoma is thicker than 1.0 mm and this operation should be performed in centers where both the operative and nuclear medicine teams are experienced. In clinically identified lymph node metastases, radical lymph node dissection is considered standard therapy. If distant metastases involve just one internal organ and operative removal is feasible, then surgery should be seen as therapy of choice. Radiation therapy for the primary treatment of melanoma is indicated only in those cases in which surgery is impossible or not reasonable. In regional lymph nodes, radiation therapy is usually recommended when excision is not complete (R1 resection) or if the nodes are inoperable. In distant metastases, radiation therapy is particularly indicated in bone metastases, brain metastases and soft tissue metastases.

journal_name

Melanoma Res

journal_title

Melanoma research

authors

Garbe C,Hauschild A,Volkenandt M,Schadendorf D,Stolz W,Reinhold U,Kortmann RD,Kettelhack C,Frerich B,Keilholz U,Dummer R,Sebastian G,Tilgen W,Schuler G,Mackensen A,Kaufmann R

doi

10.1097/CMR.0b013e3282f0c893

subject

Has Abstract

pub_date

2008-02-01 00:00:00

pages

61-7

issue

1

eissn

0960-8931

issn

1473-5636

pii

00008390-200802000-00010

journal_volume

18

pub_type

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