Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Melanoma surgery
Introduction
Overview
Overview
The predominant treatment for primary melanoma is wide excision of the lesion margins. The choice of clinical margins is based on the tumor thickness. When lymph nodes are involved, complete dissection of the nodal basin is recommended.
Surgery
Surgery
Surgical Margins for Wide Excision of Primary Melanoma
- The National Comprehensive Cancer Network (NCCN) recommends wide excision of margins of primary melanoma.
- The choice of clinical margins is based on the tumor thickness.[1]
- The margins may be individualized to accomodate anatomic and functional considerations.[1]
| Tumor thickness | Recommended Clinical Margins |
| In situ | 0.5 cm |
| ≤ 1 mm | 1 cm |
| > 1 mm – 2 mm | 1-2 cm |
| > 2 mm – 4 mm | 2 cm |
| > 4 mm | 2 cm |
To view 2019 AAD Guidelines for Surgical Treatment of Primary Cutaneous Melanoma, click here
Complete Lymph Node Dissection
The 2013 National Comprehensive Cancer Network (NCCN) recommends complete dissection of involved nodal basin is recommended.[1]
- Specific considerations for the groin lymph nodes
- Indications for iliac and obturator lymph node dissection:
- Positive pelvic CT, or
- Cloquet’s node is positive
- Elective iliac and obturator lymph node dissection
- Clinically positive superficial node, or
- ≥ 3 superficial nodes are positive
To view 2019 AAD Guidelines for Sentinal Lymph Node Biopsy, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Serge Korjian M.D. Anum Ijaz M.B.B.S., M.D.[2]