Melanoma

Abstract

The treatment of melanoma has witnessed groundbreaking changes over the last decade, transforming the standard of care for patients with high-risk, advanced or metastatic disease. Whilst the treatment approach depends on the stage of disease, the management of primary melanoma remains complete wide excision of the primary. Sentinel node biopsy is offered in selected higher risk melanoma and complete nodal dissection is performed in patients who present with palpable nodal disease. Tumour genetic analysis for BRAF mutation should be performed in all patients with stage IIB to IV disease as this will determine if patients are suitable for targeted treatment with BRAF and MEK inhibitors. Systemic treatment with targeted treatment with BRAF and MEK inhibitors and immunotherapy are recommended as adjuvant treatment options and in metastatic settings. Patients with a personal or family history of three or more melanomas require genetic assessment.