Melanoma of the Skin, Vulva, Penis and Scrotum Treatment
Surgery is the primary treatment for all stages of melanoma, particularly localized melanoma. A complete, wide local excision with sentinel lymph node biopsy and/or elective lymph node dissection is considered as standard treatment for patients with primary melanoma. Because examination of all layers of the skin is essential, shave biopsies are not recommended, and must be followed by re-excision.
Patients that present with clinically enlarged lymph nodes but no evidence of distant disease should have a complete regional lymph node dissection (LND) performed.
In absence of clinically palpable nodes, lymphatic mapping and sentinel node biopsy may be utilized to help decide whether to perform regional lymphadenectomy in patients with melanomas >1 mm in depth. If micrometastasis is found to be present in the sentinel node, lymph node dissection is performed.
Surgical treatment for patients with advanced disease involves removing metastatic tumors and/or lymph nodes, often followed by adjuvant therapy.