return to: Melanoma (Evaluation and Management) (8th Edition AJCC)
General Guidelines
5-year survival = 99% (Gershenwald et al, 2017)
|
Guidelines |
Margins |
Mohs |
SLN Biopsy |
PET |
CT |
Radiation |
Adjuvant |
|---|---|---|---|---|---|---|---|
|
European Society of Medical Oncology (ESMO) (Michielin et al, 2019) |
1 cm |
No |
No |
No |
No |
No |
No |
|
National Comprehenseive Cancer Network (NCCN) (Swetter et al, 2021) (Vetto, 2024) |
1 cm |
No |
No |
No |
No |
No |
No |
Additional comments:
ESMO: Sentinel lymph node biopsy can be discussed in pT1a for special cases (e.g. ≥3 mitoses/mm², a positive deep margin or when Breslow thickness cannot be reliably determined)
NCCN: If there is clinical uncertainty about the microstaging or, in the rare event that a conventional high-risk feature is present (e.g., ulceration, high mitotic rate, lymphovascular invasion), SLNB can be discussed
References
Gershenwald JE, Scolyer RA, Hess KR, Sondak VK, Long GV, Ross MI, Lazar AJ, Faries MB, Kirkwood JM, McArthur GA, Haydu LE, Eggermont AMM, Flaherty KT, Balch CM, Thompson JF; for members of the American Joint Committee on Cancer Melanoma Expert Panel and the International Melanoma Database and Discovery Platform. Melanoma staging: Evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin. 2017 Nov;67(6):472-492. doi: 10.3322/caac.21409. Epub 2017 Oct 13. PMID: 29028110; PMCID: PMC5978683.
Michielin, O., et al. “Cutaneous melanoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up.” Annals of Oncology, vol. 30, no. 12, Dec. 2019, pp. 1884–1901, https://doi.org/10.1093/annonc/mdz411.
Swetter, S. M., Thompson, J. A., Albertini, M. R., Barker, C. A., Baumgartner, J., Boland, G., Chmielowski, B., DiMaio, D., Durham, A., Fields, R. C., Fleming, M. D., Galan, A., Gastman, B., Grossmann, K., Guild, S., Holder, A., Johnson, D., Joseph, R. W., Karakousis, G., Kendra, K., Lange, J. R., Lanning, R., Margolin, K., Olszanski, A. J., Ott, P. A., Ross, M. I., Salama, A. K., Sharma, R., Skitzki, J., Sosman, J., Wuthrick, E., McMillian, N. R., & Engh, A. M. (2021). NCCN Guidelines® Insights: Melanoma: Cutaneous, Version 2.2021, Journal of the National Comprehensive Cancer Network J Natl Compr Canc Netw, 19(4), 364-376. Retrieved Jun 14, 2021, from https://jnccn.org/view/journals/jnccn/19/4/article-p364.xml
Vetto, John T. “Clinical and imaging follow-up for high-risk cutaneous melanoma: Current evidence and guidelines.” Cancers, vol. 16, no. 14, 18 July 2024, p. 2572, https://doi.org/10.3390/cancers16142572.