Current therapy of cutaneous melanoma

Melanoma is a growing public health problem. Optimal care of the melanoma p atient is multidisciplinary, but plastic surgeons and other surgical specia lties play a central role in the management of these patients. Although sur gery remains the mainstay of therapy for melanoma, several recent clinical studies have helped to clarify the biology of the disease and have changed the patterns of care for patients with melanoma. The advent of lymphatic ma pping for interrogation of regional lymph nodes and interferon as the first effective postsurgical adjuvant therapy have had a major impact on the car e of melanoma in the United Stares and elsewhere. This article will review the current clinical approach and therapy for cutaneous melanoma. The diagn osis, prognostic variables, staging evaluation, current surgical and medica l treatment, and follow-up guidelines for patients with all stages of melan oma are reviewed. Recent studies, controversies, and directions of future i nvestigational therapies will be discussed.