Treatment of Regional Metastatic Melanoma

Melanoma skin cancer ---> metastatic melanoma ---> regional metastasis---> melanoma treatment

Surgical excision of metastases to regional lymph nodes is potentially curative therapy. The 5-year survival rate for patients who undergo lymphadenectomy for clinically positive involved nodes (AJCC stage III) ranges from 25% to 70%. In addition, for those patients not cured by lymphadenectomy, resection can avoid potential pain associated with tumor enlargement, skin breakdown, and tumor necrosis. Only 10% of patients who first present with the diagnosis of melanoma have clinical evidence of nodal metastases; approximately 85% have localized disease; the remaining 5% have distant metastases. In less than 3% of patients, a diagnosis of melanoma is made in the absence of a definable primary lesion.28 When patients present with isolated nodal disease from an unknown primary site, the results of lymphadenectomy are similar to those for patients with known primary tumors. For patients with melanoma 1.0 mm thick or greater who present with clinically negative nodes, SLNB should be considered to determine whether therapeutic lymphadenectomy is indicated.