Surgical approach to primary cutaneous melanoma

Surgical Oncology Clinics of North America

Volumn 20, Issue 1, 2011, Pages 39-56

  Ott, Patrick A ^a   Berman, Russell S ^a  

^a NEW YORK UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Biopsy; Excision; Margins; Melanoma; Recurrence

Indexed keywords

IPILIMUMAB; PLX 4032;

BREAST; CANCER LOCALIZATION; CANCER RECURRENCE; CANCER STAGING; CANCER SURGERY; CANCER SURVIVAL; CLINICAL ASSESSMENT; COMPUTER ASSISTED TOMOGRAPHY; DESMOPLASTIC MELANOMA; EAR; FEMALE GENITAL SYSTEM; HAND; HISTOPATHOLOGY; HUMAN; MALIGNANT LENTIGO; MELANOMA; MUCOSAL MELANOMA; POSITRON EMISSION TOMOGRAPHY; PROGNOSIS; RECTUM; REVIEW; SENTINEL LYMPH NODE BIOPSY; SUBLINGUAL GLAND; SURGICAL TECHNIQUE; THORAX RADIOGRAPHY; TUMOR BIOPSY; TUMOR VOLUME;

HUMANS; HUTCHINSON'S MELANOTIC FRECKLE; IMMUNOHISTOCHEMISTRY; MELANOMA; NEOPLASM STAGING; SKIN NEOPLASMS;

EID: 78649472365     PISSN: 10553207     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.soc.2010.10.001     Document Type: Review

References (96)

1. American Cancer Society Cancer facts and figures 2008 2008, American Cancer Society, Atlanta (GA).
2. de Vries E., Coebergh J.W. Melanoma incidence has risen in Europe. BMJ 2005, 331:698.
3. Downing A., Yu X.Q., Newton-Bishop J., et al. Trends in prognostic factors and survival from cutaneous melanoma in Yorkshire, UK and New South Wales, Australia between 1993 and 2003. Int J Cancer 2008, 123:861-866.
4. Flaherty K.T., Puzanov I., Kim K.B., et al. Inhibition of mutated, activated BRAF in metastatic melanoma. N Engl J Med 2010, 363:809-819.
5. Hodi F.S., O'Day S.J., McDermott D.F., et al. Improved survival with ipilimumab in patients with metastatic melanoma. N Engl J Med 2010, 363(8):711-723.
6. Buzaid A.C., Sandler A.B., Mani S., et al. Role of computed tomography in the staging of primary melanoma. J Clin Oncol 1993, 11:638-643.
7. Terhune M.H., Swanson N., Johnson T.M. Use of chest radiography in the initial evaluation of patients with localized melanoma. Arch Dermatol 1998, 134:569-572.
8. Wagner J.D., Schauwecker D., Davidson D., et al. Inefficacy of F-18 fluorodeoxy-D-glucose-positron emission tomography scans for initial evaluation in early-stage cutaneous melanoma. Cancer 2005, 104:570-579.
9. Yancovitz M., Finelt N., Warycha M.A., et al. Role of radiologic imaging at the time of initial diagnosis of stage T1b-T3b melanoma. Cancer 2007, 110:1107-1114.
10. Sober A.J., Chuang T.Y., Duvic M., et al. Guidelines of care for primary cutaneous melanoma. J Am Acad Dermatol 2001, 45:579-586.
11. Goldman L.I. The surgical therapy of malignant melanomas. Semin Oncol 1975, 2:175-178.
12. Handley The Hunterian lectures on the pathology of melanotic growths in relation to their operative treatment. Lancet 1907, 1:927-953.
13. Petersen N.C., Bodenham D.C., Lloyd O.C. Malignant melanomas of the skin. A study of the origin, development, aetiology, spread, treatment, and prognosis. Br J Plast Surg 1962, 15:97-116.
14. Breslow A., Macht S.D. Optimal size of resection margin for thin cutaneous melanoma. Surg Gynecol Obstet 1977, 145:691-692.
15. Aitken D.R., James A.G., Carey L.C. Local cutaneous recurrence after conservative excision of malignant melanoma. Arch Surg 1984, 119:643-646.
16. Balch C.M., Murad T.M., Soong S.J., et al. Tumor thickness as a guide to surgical management of clinical stage I melanoma patients. Cancer 1979, 43:883-888.
17. Veronesi U., Cascinelli N. Narrow excision (1-cm margin). A safe procedure for thin cutaneous melanoma. Arch Surg 1991, 126:438-441.
18. Veronesi U., Cascinelli N., Adamus J., et al. Thin stage I primary cutaneous malignant melanoma. Comparison of excision with margins of 1 or 3 cm. N Engl J Med 1988, 318:1159-1162.
19. Cohn-Cedermark G., Rutqvist L.E., Andersson R., et al. Long term results of a randomized study by the Swedish Melanoma Study Group on 2-cm versus 5-cm resection margins for patients with cutaneous melanoma with a tumor thickness of 0.8-2.0 mm. Cancer 2000, 89:1495-1501.
20. Ringborg U., Andersson R., Eldh J., et al. Resection margins of 2 versus 5 cm for cutaneous malignant melanoma with a tumor thickness of 0.8 to 2.0 mm: randomized study by the Swedish Melanoma Study Group. Cancer 1996, 77:1809-1814.
21. Khayat D., Rixe O., Martin G., et al. Surgical margins in cutaneous melanoma (2 cm versus 5 cm for lesions measuring less than 2.1-mm thick). Cancer 2003, 97:1941-1946.
22. Balch C.M., Urist M.M., Karakousis C.P., et al. Efficacy of 2-cm surgical margins for intermediate-thickness melanomas (1 to 4 mm). Results of a multi-institutional randomized surgical trial. Ann Surg 1993, 218:262-267. [discussion: 7-9].
23. Karakousis C.P., Balch C.M., Urist M.M., et al. Local recurrence in malignant melanoma: long-term results of the multiinstitutional randomized surgical trial. Ann Surg Oncol 1996, 3:446-452.
24. Balch C.M., Soong S.J., Smith T., et al. Long-term results of a prospective surgical trial comparing 2 cm vs 4 cm excision margins for 740 patients with 1-4 mm melanomas. Ann Surg Oncol 2001, 8:101-108.
25. Randomized trial of a resection margin of 2 cm versus 4 cm for cutaneous malignant melanoma with a tumor thickness of more than 2 mm. In: Proceedings 6th World Melanoma. 2005.
26. Thomas J.M., Newton-Bishop J., A'Hern R., et al. Excision margins in high-risk malignant melanoma. N Engl J Med 2004, 350:757-766.
27. Ringborg U, Brahme E, Drewiecki K. Randomized trial of a resection margin of 2 cm versus 4 cm for cutaneous malignant melanoma with a tumor thickness of more than 2 mm. In: World Congress on Melanoma. September 5-10, Vancouver (BC): Canadian Melanoma Society, University of British Columbia, BC Cancer Agency; 2005.
28. Heaton K.M., Sussman J.J., Gershenwald J.E., et al. Surgical margins and prognostic factors in patients with thick (>4 mm) primary melanoma. Ann Surg Oncol 1998, 5:322-328.
29. Lens M.B., Nathan P., Bataille V. Excision margins for primary cutaneous melanoma: updated pooled analysis of randomized controlled trials. Arch Surg 2007, 142:885-891. [discussion: 91-3].
30. Kenady D.E., Brown B.W., McBride C.M. Excision of underlying fascia with a primary malignant melanoma: effect on recurrence and survival rates. Surgery 1982, 92:615-618.
31. Balch C.M., Buzaid A.C., Soong S.J., et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol 2001, 19:3635-3648.
32. Morton D.L., Wen D.R., Wong J.H., et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 1992, 127:392-399.
33. Balch C.M., Morton D.L., Gershenwald J.E., et al. Sentinel node biopsy and standard of care for melanoma. J Am Acad Dermatol 2009, 60:872-875.
34. Gershenwald J.E., Thompson W., Mansfield P.F., et al. Multi-institutional melanoma lymphatic mapping experience: the prognostic value of sentinel lymph node status in 612 stage I or II melanoma patients. J Clin Oncol 1999, 17:976-983.
35. Morton D.L., Thompson J.F., Cochran A.J., et al. Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med 2006, 355:1307-1317.
36. Morton D.L., Thompson J.F., Essner R., et al. Validation of the accuracy of intraoperative lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: a multicenter trial. Multicenter Selective Lymphadenectomy Trial Group. Ann Surg 1999, 230:453-463. [discussion: 63-5].
37. Testori A., De Salvo G.L., Montesco M.C., et al. Clinical considerations on sentinel node biopsy in melanoma from an Italian multicentric study on 1,313 patients (SOLISM-IMI). Ann Surg Oncol 2009, 16:2018-2027.
38. Albertini J.J., Cruse C.W., Rapaport D., et al. Intraoperative radio-lympho-scintigraphy improves sentinel lymph node identification for patients with melanoma. Ann Surg 1996, 223:217-224.
39. Krag D.N., Meijer S.J., Weaver D.L., et al. Minimal-access surgery for staging of malignant melanoma. Arch Surg 1995, 130:654-658. [discussion: 9-60].
40. Balch C.M., Soong S.J., Bartolucci A.A., et al. Efficacy of an elective regional lymph node dissection of 1 to 4 mm thick melanomas for patients 60 years of age and younger. Ann Surg 1996, 224:255-263. [discussion: 63-6].
41. Cascinelli N., Morabito A., Santinami M., et al. Immediate or delayed dissection of regional nodes in patients with melanoma of the trunk: a randomised trial. WHO melanoma programme. Lancet 1998, 351:793-796.
42. Sim F.H., Taylor W.F., Ivins J.C., et al. A prospective randomized study of the efficacy of routine elective lymphadenectomy in management of malignant melanoma. Preliminary results. Cancer 1978, 41:948-956.
43. Veronesi U., Adamus J., Bandiera D.C., et al. Inefficacy of immediate node dissection in stage 1 melanoma of the limbs. N Engl J Med 1977, 297:627-630.
44. Veronesi U., Adamus J., Bandiera D.C., et al. Delayed regional lymph node dissection in stage I melanoma of the skin of the lower extremities. Cancer 1982, 49:2420-2430.
45. Cecchi R., Buralli L., Innocenti S., et al. Sentinel lymph node biopsy in patients with thin melanomas. J Dermatol 2007, 34:512-515.
46. Hershko D.D., Robb B.W., Lowy A.M., et al. Sentinel lymph node biopsy in thin melanoma patients. J Surg Oncol 2006, 93:279-285.
47. Ranieri J.M., Wagner J.D., Wenck S., et al. The prognostic importance of sentinel lymph node biopsy in thin melanoma. Ann Surg Oncol 2006, 13:927-932.
48. Wong S.L., Brady M.S., Busam K.J., et al. Results of sentinel lymph node biopsy in patients with thin melanoma. Ann Surg Oncol 2006, 13:302-309.
49. Wright B.E., Scheri R.P., Ye X., et al. Importance of sentinel lymph node biopsy in patients with thin melanoma. Arch Surg 2008, 143:892-899. [discussion: 899-900].
50. Brady M.S., Coit D.G. Sentinel lymph node evaluation in melanoma. Arch Dermatol 1997, 133:1014-1020.
51. Rossi C.R., Seno A., Vecchiato A., et al. The impact of ultrasound scanning in the staging and follow-up of patients with clinical stage I cutaneous melanoma. Eur J Cancer 1997, 33:200-203.
52. Voit C., Mayer T., Kron M., et al. Efficacy of ultrasound B-scan compared with physical examination in follow-up of melanoma patients. Cancer 2001, 91:2409-2416.
53. Voit C.A., van Akkooi A.C., Schafer-Hesterberg G., et al. Rotterdam Criteria for sentinel node (SN) tumor burden and the accuracy of ultrasound (US)-guided fine-needle aspiration cytology (FNAC): can US-guided FNAC replace SN staging in patients with melanoma?. J Clin Oncol 2009, 27:4994-5000.
54. Sanki A., Uren R.F., Moncrieff M., et al. Targeted high-resolution ultrasound is not an effective substitute for sentinel lymph node biopsy in patients with primary cutaneous melanoma. J Clin Oncol 2009, 27:5614-5619.
55. Posther K.E., Selim M.A., Mosca P.J., et al. Histopathologic characteristics, recurrence patterns, and survival of 129 patients with desmoplastic melanoma. Ann Surg Oncol 2006, 13:728-739.
56. Pawlik T.M., Ross M.I., Prieto V.G., et al. Assessment of the role of sentinel lymph node biopsy for primary cutaneous desmoplastic melanoma. Cancer 2006, 106:900-906.
57. Gyorki D.E., Busam K., Panageas K., et al. Sentinel lymph node biopsy for patients with cutaneous desmoplastic melanoma. Ann Surg Oncol 2003, 10:403-407.
58. Coleman W.P., Davis R.S., Reed R.J., et al. Treatment of lentigo maligna and lentigo maligna melanoma. J Dermatol Surg Oncol 1980, 6:476-479.
59. Osborne J.E., Hutchinson P.E. A follow-up study to investigate the efficacy of initial treatment of lentigo maligna with surgical excision. Br J Plast Surg 2002, 55:611-615.
60. Pitman G.H., Kopf A.W., Bart R.S., et al. Treatment of lentigo maligna and lentigo maligna melanoma. J Dermatol Surg Oncol 1979, 5:727-737.
61. Tsang R.W., Liu F.F., Wells W., et al. Lentigo maligna of the head and neck. Results of treatment by radiotherapy. Arch Dermatol 1994, 130:1008-1012.
62. Clinical practice guidelines in oncology: melanoma Available at:, Accessed September 1, 2010. http://www.nccn.org/professionals/physician_gls/PDF/melanoma.pdf.
63. Bricca G.M., Brodland D.G., Ren D., et al. Cutaneous head and neck melanoma treated with Mohs micrographic surgery. J Am Acad Dermatol 2005, 52:92-100.
64. Agarwal-Antal N., Bowen G.M., Gerwels J.W. Histologic evaluation of lentigo maligna with permanent sections: implications regarding current guidelines. J Am Acad Dermatol 2002, 47:743-748.
65. Huilgol S.C., Selva D., Chen C., et al. Surgical margins for lentigo maligna and lentigo maligna melanoma: the technique of mapped serial excision. Arch Dermatol 2004, 140:1087-1092.
66. Zalla M.J., Lim K.K., Dicaudo D.J., et al. Mohs micrographic excision of melanoma using immunostains. Dermatol Surg 2000, 26:771-784.
67. El Tal A.K., Abrou A.E., Stiff M.A., et al. Immunostaining in Mohs micrographic surgery: a review. Dermatol Surg 2010, 36:275-290.
68. Dawn M.E., Dawn A.G., Miller S.J. Mohs surgery for the treatment of melanoma in situ: a review. Dermatol Surg 2007, 33:395-402.
69. Erickson C., Miller S.J. Treatment options in melanoma in situ: topical and radiation therapy, excision and Mohs surgery. Int J Dermatol 2010, 49:482-491.
70. Bub J.L., Berg D., Slee A., et al. Management of lentigo maligna and lentigo maligna melanoma with staged excision: a 5-year follow-up. Arch Dermatol 2004, 140:552-558.
71. Clayton B.D., Leshin B., Hitchcock M.G., et al. Utility of rush paraffin-embedded tangential sections in the management of cutaneous neoplasms. Dermatol Surg 2000, 26:671-678.
72. Bene N.I., Healy C., Coldiron B.M. Mohs micrographic surgery is accurate 95.1% of the time for melanoma in situ: a prospective study of 167 cases. Dermatol Surg 2008, 34:660-664.
73. Zitelli J.A., Brown C., Hanusa B.H. Mohs micrographic surgery for the treatment of primary cutaneous melanoma. J Am Acad Dermatol 1997, 37:236-245.
74. Clark G.S., Pappas-Politis E.C., Cherpelis B.S., et al. Surgical management of melanoma in situ on chronically sun-damaged skin. Cancer Control 2008, 15:216-224.
75. Chang A.E., Karnell L.H., Menck H.R. The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer 1998, 83:1664-1678.
76. McLaughlin C.C., Wu X.C., Jemal A., et al. Incidence of noncutaneous melanomas in the U.S. Cancer 2005, 103:1000-1007.
77. Curtin J.A., Busam K., Pinkel D., et al. Somatic activation of KIT in distinct subtypes of melanoma. J Clin Oncol 2006, 24:4340-4346.
78. Curtin J.A., Fridlyand J., Kageshita T., et al. Distinct sets of genetic alterations in melanoma. N Engl J Med 2005, 353:2135-2147.
79. Davies H., Bignell G.R., Cox C., et al. Mutations of the BRAF gene in human cancer. Nature 2002, 417:949-954.
80. Gorden A., Osman I., Gai W., et al. Analysis of BRAF and N-RAS mutations in metastatic melanoma tissues. Cancer Res 2003, 63:3955-3957.
81. Patrick R.J., Fenske N.A., Messina J.L. Primary mucosal melanoma. J Am Acad Dermatol 2007, 56:828-834.
82. Manolidis S., Donald P.J. Malignant mucosal melanoma of the head and neck: review of the literature and report of 14 patients. Cancer 1997, 80:1373-1386.
83. Stern S.J., Guillamondegui O.M. Mucosal melanoma of the head and neck. Head Neck 1991, 13:22-27.
84. Patel S.G., Prasad M.L., Escrig M., et al. Primary mucosal malignant melanoma of the head and neck. Head Neck 2002, 24:247-257.
85. Tomicic J., Wanebo H.J. Mucosal melanomas. Surg Clin North Am 2003, 83:237-252.
86. Owens J.M., Roberts D.B., Myers J.N. The role of postoperative adjuvant radiation therapy in the treatment of mucosal melanomas of the head and neck region. Arch Otolaryngol Head Neck Surg 2003, 129:864-868.
87. Mendenhall W.M., Amdur R.J., Hinerman R.W., et al. Head and neck mucosal melanoma. Am J Clin Oncol 2005, 28:626-630.
88. Wagner M., Morris C.G., Werning J.W., et al. Mucosal melanoma of the head and neck. Am J Clin Oncol 2008, 31:43-48.
89. Brady M.S., Kavolius J.P., Quan S.H. Anorectal melanoma. A 64-year experience at Memorial Sloan-Kettering Cancer Center. Dis Colon Rectum 1995, 38:146-151.
90. Ballo M.T., Gershenwald J.E., Zagars G.K., et al. Sphincter-sparing local excision and adjuvant radiation for anal-rectal melanoma. J Clin Oncol 2002, 20:4555-4558.
91. Yeh J.J., Shia J., Hwu W.J., et al. The role of abdominoperineal resection as surgical therapy for anorectal melanoma. Ann Surg 2006, 244:1012-1017.
92. Ragnarsson-Olding B.K., Nilsson B.R., Kanter-Lewensohn L.R., et al. Malignant melanoma of the vulva in a nationwide, 25-year study of 219 Swedish females: predictors of survival. Cancer 1999, 86:1285-1293.
93. Rogo K.O., Andersson R., Edbom G., et al. Conservative surgery for vulvovaginal melanoma. Eur J Gynaecol Oncol 1991, 12:113-119.
94. Phillips G.L., Bundy B.N., Okagaki T., et al. Malignant melanoma of the vulva treated by radical hemivulvectomy. A prospective study of the Gynecologic Oncology Group. Cancer 1994, 73:2626-2632.
95. Rose P.G., Piver M.S., Tsukada Y., et al. Conservative therapy for melanoma of the vulva. Am J Obstet Gynecol 1988, 159:52-55.
96. Trimble E.L., Lewis J.L., Williams L.L., et al. Management of vulvar melanoma. Gynecol Oncol 1992, 45:254-258.