The Surgical Management of Cutaneous Melanoma

Abstract

Cutaneous melanoma is a highly aggressive malignancy originating from melanocytes. It frequently occurs on the head/neck where it is often diagnosed at advanced stages and associated with poorer outcomes compared to the trunk and extremities. Wide local excision remains the standard-of-care for localized disease; however, Mohs micrographic surgery offers superior local control for melanomas in cosmetically sensitive areas. Sentinel lymph node biopsy remains essential for staging. Recent advances in adjuvant and neoadjuvant therapies have improved survival, while innovations in genetic profiling, prediction tools, and tailored imaging are enhancing personalized treatment, accurate staging and detection, resulting in better patient outcomes.

Keywords: Adjuvant therapy; Immune checkpoint inhibitors; Melanoma; Mohs micrographic surgery; Neoadjuvant therapy; Sentinel lymph node biopsy; Surgery; Wide local excision.