Surgical Management of Melanoma

Abstract

This chapter discusses the surgical principles in the management of melanoma. Surgery remains the mainstay of treatment of primary melanoma, and in the majority of cases it is curative. Appropriate surgical management is critical for the diagnosis, staging, and optimal treatment of both in situ and invasive primary cutaneous melanoma. Surgical management is dependent on the stage of the disease, and therefore this chapter evaluates localized, regional, and metastatic disease. The concept of sentinel lymph node biopsy is discussed along with its benefits, pitfalls, and prognostic significance. Furthermore, several important surgical issues are discussed, including the extent of surgical margins, Mohs micrographic surgery for melanoma in situ, and the role of metastasectomy.

Overexpression of CDCA8 promotes the malignant progression of cutaneous melanoma and leads to poor prognosis

“…Cutaneous melanoma is transformed from melanocytes, and the predominant cause of melanoma is believed to be long-term UV irradiation ( 1 ). Melanoma has a highly invasive nature; even a primary tumor with a diameter of 2.5-4 mm can metastasize to multiple organs in the whole body, leading to a very poor prognosis ( 2 , 3 ). In 2014, there were >76,000 new cases of melanoma in the United States and >9,000 patients succumbed to melanoma ( 4 ).…”

“…In 2014, there were >76,000 new cases of melanoma in the United States and >9,000 patients succumbed to melanoma ( 4 ). Sadly, at present, the 5-year overall survival (OS) rate for patients with stage IV melanoma is <15% ( 5 , 6 ) Furthermore, patients suffering from metastatic melanoma have a poor prognosis ( 1 , 3 ). Thus, identifying novel biomarkers related to the prognosis and progression of melanoma may improve the treatment and outcomes for patients with melanoma.…”

Molecular Investigation of miRNA Biomarkers as Chemoresistance Regulators in Melanoma: A Protocol for Systematic Review and Meta-Analysis

“…Several studies have focused on miRNAs’ impact on chemotherapeutic resistance in cancers, including breast cancer [ 19 ], cervical cancer [ 20 ], colorectal cancer [ 21 ], gastric cancer [ 22 ], lung cancer [ 23 ], oral cancer [ 24 ], ovarian cancer [ 25 ], pancreatic cancer [ 26 ] prostate cancer [ 27 ], and skin cancer [ 28 ]. With a 5-year survival rate of 92 percent, surgery remains the best choice for curing localized, invasive melanoma [ 29 ]. The molecular basis of melanoma resistance to chemotherapy is thought to be multifactorial, with a defective drug transport system, an altered apoptotic pathway, apoptosis deregulation, and changes in the enzymatic systems that mediate cellular metabolic machinery all contributing to chemotherapy complications [ 30 ].…”

Liquid Biopsy in Melanoma: Significance in Diagnostics, Prediction and Treatment Monitoring

“…Conventional melanoma treatments start from surgical lesion removal and biopsy assessment [ 3 ]. As the currently used methods of cancer treatment, including chemotherapy and radiotherapy (RT), are often less effective, invasive, and cause significant complications for patient health and wellbeing, significant effort is placed on the development of more targeted approaches [ 4 ].…”