Contemporary Surgical Treatment of Advanced-Stage Melanoma

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Abstract
Once an uncommon malignancy, cutaneous melanoma is rapidly becoming a major health concern in the United States. It is estimated that 55 100 Americans will develop melanoma in 2004 and that 7910 will ultimately die.1 Melanoma is the fifth most common cancer in men and the sixth most common in women, representing 4.5% of all cancer cases in the United States. Although most cases of cutaneous melanoma are cured by excision of the primary tumor, about 30% of patients will develop metastases. The treatment of advanced-stage melanoma is controversial. During the last 30 years, chemotherapy, immunotherapy, and biologics have had no effect on overall survival. The results from many studies raise the question of whether surgery should be incorporated into the care of patients with advanced-stage disease.2-5