Surgical treatment of malignant melanoma of the skin

摘要

abstract_textpThe significant increase in the incidence of malignant melanoma and its precursors together with improved survival rates result in a tremendous rise in prevalence worldwide. For Germany the Robert Koch Institute estimated a projected 5-year prevalence of 37,900 women and 27,600 men for the year 2010 based on the German cancer data registration. Surgical excision is the first choice therapy for primary malignant melanoma. Based on several prospective trials guidelines are recommended for lateral safety margins for excision depending on tumor thickness ranging from 0.5 cm to 2 cm. Diagnostic incision biopsies are only indicated in a few relatively rare conditions, e.g. in cases of clinical suspicion of extensive lentigo maligna in the face or unclear changes in pigmentation of the skin and mucosa. In anatomically difficult areas such as the face and acral localizations the recommended safety margins can be reduced by application of micrographic-controlled surgery to avoid mutilating interventions./p/abstract_text