DIAGNOSIS AND MANAGEMENT OF EARLY MELANOMA - A CONSENSUS VIEW

The inefficacy of treatments for advanced melanoma have shifted the fo cus toward the recognition of early melanoma which is associated with a much more favorable outcome. In January 1992 the National Institutes of Health (NIH) held a Consensus Conference to establish definitions and therapeutic recommendations for the management of early melanoma. Early melanoma was defined as either in situ or invasive melanoma < 1 mm in depth. Surgical margins of 0.5 cm for in situ melanoma, and 1 cm for invasive melanoma less-than-or-equal-to 1 mm thick were recommend ed. The pathology reports should include as a minimum the diagnosis of melanoma, the maximum tumor thickness, and the status of the margins. Elective nodal dissection as well as high-tech radiologic procedures were not recommended. Follow-up of patients for the development of sec ond primaries and of family members who may be at increased risk for M elanoma was also recommended. Public education programs were suggested to inform the public of the increasing melanoma risk and improved sur vival through early detection.