Review Article

Diagnosis, Evaluation, and Surgical Management of Melanoma

Brianna Hoffner, MSN, ANP-BC, AOCNP®, and Christan G. Bartsch, MSHS, PA-C, MPH

Department of Medical Oncology, University of Colorado Cancer Center, Aurora, Colorado; and Department of Surgical Oncology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado

Authors’ disclosures of conflicts of interest are found at the end of this article.

Brianna Hoffner, MSN, ANP-BC, AOCNP®, University of Colorado— Medical Oncology, 1665 Aurora Court, 2nd floor, Aurora, CO 80045 E-mail: brianna.hoffner@ucdenver.edu


J Adv Pract Oncol 2018;9(suppl 1):11–19 | https://doi.org/10.6004/jadpro.2018.9.7.10 | © 2018 Harborside™


  

ABSTRACT

Abstract

Melanoma accounts for 5.3% of all new cancer diagnoses, with increasing rates over the past 4 decades. Risk factors include multiple nevi, family history, sun exposure, immunosuppression, and environmental exposure. Ongoing public health efforts are important in decreasing these associated risk factors. Early detection of melanoma is crucial, and may be achieved by using the “ABCDE rule” (asymmetry, border, color, diameter, evolution). Staging of melanoma with the TNM staging system determines treatment and prognosis. Surgery with wide local excision is the treatment for primary melanoma. Thickness of the primary lesion is the main predictor of sentinel lymph node involvement and determines the need for sentinel lymph node biopsy. Staging is important in determining the need for surveillance, as the 5-year survival rate is 98% for local disease as compared to 17% among patients with distant metastasis.




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