Abstract

The surgical management of melanoma has evolved over the last several decades based on the published results and long-term follow up of several randomized clinical trials. While management of primary, localized melanoma is generally established, the management of clinically-positive metastasis, recurrent disease or distant melanoma is less clear. Controversies regarding the current surgical management of melanoma remain including the utility of sentinel lymph node biopsy for thin/thick melanoma, the role of completion lymphadenectomy for micrometastatic disease, and the indication for metastectomy for distant disease in the era of targeted therapy, as well as many others. Some of these concerns are being addressed in clinical trials while others remain unanswered. This review addresses these concepts and several others which represent current surgical controversies in the management of melanoma.

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