Vol 5, No 1 (2009)
Guidelines / Expert consensus
Published online: 2009-02-02
Cutaneous melanoma - diagnostic and therapeutic guidelines
Onkol. Prak. Klin 2009;5(1):20-32.
Abstract
Excisional biopsy of suspicious melanomatous skin lesions likely to be diagnosed as early melanomas is
crucial in establishing diagnosis and prognostic factors. Early diagnosis and surgical removal of cutaneous
melanoma not only improves patients’ prognosis, but it is also associated with approximately 90% likelihood
of cure. Next steps in the therapeutical management of cutaneous melanoma following excisional biopsy are
radical scar excision with adequate margins and sentinel lymph node biopsy. Radical lymph node dissection
is recommended in case of regional lymph node metastases. High-risk patients should be enrolled into
prospective clinical trials on adjuvant therapy. The treatment of melanoma patients with distant metastases is of limited value. Long-term survival is confined to selected group of patients (metastases to extra-regional
nodes, subcutaneous tissue and lungs). The benefits of immunotherapy/immunochemotherapy as compared
to dacarbazine monotherapy have not been proven. Patients with metastatic disease should be
treated within the frame of clinical trials.
Keywords: cutaneous melanomadiagnosticstherapy
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