NCCN Guidelines for Patients® | Melanoma - page 54

54
NCCN Guidelines for Patients
®
: Melanoma
Version 1.2013
Part 6: A step-by-step treatment guide
Part 6.2.2 describes the recommended treatments for
stages 0, I, and II melanoma. The primary treatment
for these tumors is a wide excision—surgery to remove
the whole tumor and some surrounding normal tissue.
The normal-looking tissue around the edge of the tumor
removed during surgery is called the surgical margin.
The size of the surgical margin depends mostly on the
thickness of the tumor (Table 4). For lentigo maligna
melanoma, wider margins may be needed, particularly
on the face.
Under certain circumstances when surgery is not
possible for melanoma in situ, particularly lentigo maligna
type on the face, your doctor may discuss other treatment
options. These may include imiquimod cream and
radiation therapy.
Adjuvant treatment
Primary treatment
6.2.2 Primary and adjuvant treatment
Clinical stage
Wide excision
Stage 0
Stage IA or IB
(≤0.75 mm thick)
Stage IA
(0.76–1 mm thick)
Stage IB
(0.76–1 mm thick)
Stage IIA
Stage IIB or IIC
Wide excision +
sentinel lymph
node biopsy
Wide excision +
sentinel lymph
node biopsy
Wide excision +
sentinel lymph
node biopsy
Observation
Observation
Clinical trial, or
Observation
Clinical trial,
Observation, or
Interferon alfa
1...,44,45,46,47,48,49,50,51,52,53 55,56,57,58,59,60,61,62,63,64,...108
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