Melanoma treatment, different tumors have different treatment methods

A common symptom of melanoma is regional lymph node metastasis, which may even spread to the lungs, liver and other parts of the body in severe cases. There are many methods for treating this disease, including palliative resection for melanoma, combined surgery with other treatments for melanoma, biopsy surgery for melanoma, etc.

1. Palliative resection for melanoma

For patients with large lesions and distant metastases who are not suitable for radical surgery, debulking surgery or palliative resection may be considered to relieve ulcer bleeding or pain, as long as anatomical conditions permit.

2. Comprehensive treatment of melanoma with surgery combined with other treatment methods

Surgery combined with chemotherapy and/or immunotherapy aims to improve efficacy and prolong survival.

3. Biopsy and surgery for melanoma

For patients suspected of having malignant melanoma, the lesion together with the surrounding 0.5-1 cm of normal skin and subcutaneous fat should be removed in one piece for pathological examination. If it is confirmed to be malignant melanoma, the need for additional extensive resection will be determined based on the depth of infiltration.

Incisional or forceps biopsy is generally not performed unless the lesion has already ulcerated or the lesion is so large that single excision will cause disfigurement or disability and must be confirmed by pathology first. However, the incisional biopsy must be linked to radical surgery as closely as possible.

4. Treatment of melanoma with wide resection of the primary lesion

As early as the early 19th century, people had noticed that malignant melanoma had a high local recurrence rate after local resection. Based on this, malignant melanoma must be subjected to wide resection 3-5 cm away from the primary lesion, which reduces the local recurrence rate to about 7%.

5. Regional lymph node dissection for melanoma

The scope of lymph node clearance often varies with the location of the primary lesion. It is applicable to patients in clinical stage I who only need to undergo wide resection of the lesion and then be closely followed up. If suspected metastasis is found, regional lymph node dissection will have no adverse effect on prognosis, and can save about 80% of clinical stage I patients from the pain of regional lymph node dissection. Regional lymph node dissection should be performed for lesions with thickness > 1.5 mm and Clark lever III.