Surgery and radiotherapy in the treatment of cutaneous melanoma

A Testori, P Rutkowski, J Marsden, L Bastholt, V Chiarion-Sileni, A Hauschild, A M M Eggermont

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Adequate surgical management of primary melanoma and regional lymph node metastasis, and rarely distant metastasis, is the only established curative treatment. Surgical management of primary melanomas consists of excisions with 1-2 cm margins and primary closure. The recommended method of biopsy is excisional biopsy with a 2 mm margin and a small amount of subcutaneous fat. In specific situations (very large lesions or certain anatomical areas), full-thickness incisional or punch biopsy may be acceptable. Sentinel lymph node biopsy provides accurate staging information for patients with clinically unaffected regional nodes and without distant metastases, although survival benefit has not been proved. In cases of positive sentinel node biopsy or clinically detected regional nodal metastases (palpable, positive cytology or histopathology), radical removal of lymph nodes of the involved basin is indicated. For resectable local/in-transit recurrences, excision with a clear margin is recommended. For numerous or unresectable in-transit metastases of the extremities, isolated limb perfusion or infusion with melphalan should be considered. Decisions about surgery of distant metastases should be based on individual circumstances. Radiotherapy is indicated as a treatment option in select patients with lentigo maligna melanoma and as an adjuvant in select patients with regional metastatic disease. Radiotherapy is also indicated for palliation, especially in bone and brain metastases.
Original languageEnglish
JournalAnnals of Oncology
Volume20 Suppl 6
Pages (from-to)vi22-9
ISSN0923-7534
DOIs
Publication statusPublished - 1. Aug 2009

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Melanoma
Skin
Lymph Nodes
Hutchinson's Melanotic Freckle
Sentinel Lymph Node Biopsy
Melphalan
Subcutaneous Fat
Cell Biology
Perfusion

Keywords

  • Humans
  • Melanoma
  • Skin Neoplasms

Cite this

Testori, A., Rutkowski, P., Marsden, J., Bastholt, L., Chiarion-Sileni, V., Hauschild, A., & Eggermont, A. M. M. (2009). Surgery and radiotherapy in the treatment of cutaneous melanoma. Annals of Oncology, 20 Suppl 6, vi22-9. https://doi.org/10.1093/annonc/mdp257
Testori, A ; Rutkowski, P ; Marsden, J ; Bastholt, L ; Chiarion-Sileni, V ; Hauschild, A ; Eggermont, A M M. / Surgery and radiotherapy in the treatment of cutaneous melanoma. In: Annals of Oncology. 2009 ; Vol. 20 Suppl 6. pp. vi22-9.
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abstract = "Adequate surgical management of primary melanoma and regional lymph node metastasis, and rarely distant metastasis, is the only established curative treatment. Surgical management of primary melanomas consists of excisions with 1-2 cm margins and primary closure. The recommended method of biopsy is excisional biopsy with a 2 mm margin and a small amount of subcutaneous fat. In specific situations (very large lesions or certain anatomical areas), full-thickness incisional or punch biopsy may be acceptable. Sentinel lymph node biopsy provides accurate staging information for patients with clinically unaffected regional nodes and without distant metastases, although survival benefit has not been proved. In cases of positive sentinel node biopsy or clinically detected regional nodal metastases (palpable, positive cytology or histopathology), radical removal of lymph nodes of the involved basin is indicated. For resectable local/in-transit recurrences, excision with a clear margin is recommended. For numerous or unresectable in-transit metastases of the extremities, isolated limb perfusion or infusion with melphalan should be considered. Decisions about surgery of distant metastases should be based on individual circumstances. Radiotherapy is indicated as a treatment option in select patients with lentigo maligna melanoma and as an adjuvant in select patients with regional metastatic disease. Radiotherapy is also indicated for palliation, especially in bone and brain metastases.",
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Testori, A, Rutkowski, P, Marsden, J, Bastholt, L, Chiarion-Sileni, V, Hauschild, A & Eggermont, AMM 2009, 'Surgery and radiotherapy in the treatment of cutaneous melanoma', Annals of Oncology, vol. 20 Suppl 6, pp. vi22-9. https://doi.org/10.1093/annonc/mdp257

Surgery and radiotherapy in the treatment of cutaneous melanoma. / Testori, A; Rutkowski, P; Marsden, J; Bastholt, L; Chiarion-Sileni, V; Hauschild, A; Eggermont, A M M.

In: Annals of Oncology, Vol. 20 Suppl 6, 01.08.2009, p. vi22-9.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Surgery and radiotherapy in the treatment of cutaneous melanoma

AU - Testori, A

AU - Rutkowski, P

AU - Marsden, J

AU - Bastholt, L

AU - Chiarion-Sileni, V

AU - Hauschild, A

AU - Eggermont, A M M

PY - 2009/8/1

Y1 - 2009/8/1

N2 - Adequate surgical management of primary melanoma and regional lymph node metastasis, and rarely distant metastasis, is the only established curative treatment. Surgical management of primary melanomas consists of excisions with 1-2 cm margins and primary closure. The recommended method of biopsy is excisional biopsy with a 2 mm margin and a small amount of subcutaneous fat. In specific situations (very large lesions or certain anatomical areas), full-thickness incisional or punch biopsy may be acceptable. Sentinel lymph node biopsy provides accurate staging information for patients with clinically unaffected regional nodes and without distant metastases, although survival benefit has not been proved. In cases of positive sentinel node biopsy or clinically detected regional nodal metastases (palpable, positive cytology or histopathology), radical removal of lymph nodes of the involved basin is indicated. For resectable local/in-transit recurrences, excision with a clear margin is recommended. For numerous or unresectable in-transit metastases of the extremities, isolated limb perfusion or infusion with melphalan should be considered. Decisions about surgery of distant metastases should be based on individual circumstances. Radiotherapy is indicated as a treatment option in select patients with lentigo maligna melanoma and as an adjuvant in select patients with regional metastatic disease. Radiotherapy is also indicated for palliation, especially in bone and brain metastases.

AB - Adequate surgical management of primary melanoma and regional lymph node metastasis, and rarely distant metastasis, is the only established curative treatment. Surgical management of primary melanomas consists of excisions with 1-2 cm margins and primary closure. The recommended method of biopsy is excisional biopsy with a 2 mm margin and a small amount of subcutaneous fat. In specific situations (very large lesions or certain anatomical areas), full-thickness incisional or punch biopsy may be acceptable. Sentinel lymph node biopsy provides accurate staging information for patients with clinically unaffected regional nodes and without distant metastases, although survival benefit has not been proved. In cases of positive sentinel node biopsy or clinically detected regional nodal metastases (palpable, positive cytology or histopathology), radical removal of lymph nodes of the involved basin is indicated. For resectable local/in-transit recurrences, excision with a clear margin is recommended. For numerous or unresectable in-transit metastases of the extremities, isolated limb perfusion or infusion with melphalan should be considered. Decisions about surgery of distant metastases should be based on individual circumstances. Radiotherapy is indicated as a treatment option in select patients with lentigo maligna melanoma and as an adjuvant in select patients with regional metastatic disease. Radiotherapy is also indicated for palliation, especially in bone and brain metastases.

KW - Humans

KW - Melanoma

KW - Skin Neoplasms

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JO - Annals of Oncology

JF - Annals of Oncology

SN - 0923-7534

ER -

Testori A, Rutkowski P, Marsden J, Bastholt L, Chiarion-Sileni V, Hauschild A et al. Surgery and radiotherapy in the treatment of cutaneous melanoma. Annals of Oncology. 2009 Aug 1;20 Suppl 6:vi22-9. https://doi.org/10.1093/annonc/mdp257