NCCN Guidelines for Patients® | Melanoma

55 NCCN Guidelines for Patients ® : Melanoma, 2018 5  Treatment guide In situ and local melanoma In situ and local melanoma Guide 9 shows the primary treatment options for stage 0, I, and II melanomas. Primary treatment is the main treatment used to rid the body of cancer. Adjuvant treatment is additional treatment given after the main one to try to kill any remaining cancer cells and lower the chance that the cancer will come back. The return of cancer after a period of improvement is called a recurrence. For local melanomas of stage 0 or IA, the chance of metastasis or recurrence is low. Thus, surgery to remove the primary tumor is the only treatment needed. However, some local melanomas may have certain features that increase the chance of metastasis or recurrence. For these melanomas, additional staging and treatments may be needed. Guide 9. Primary treatment and next steps of care Clinical stage Primary treatment Next steps • Stage 0 (in situ) • Stage IA (<0.8 mm thick, no ulceration) ª • Wide excision ª • Follow-up care (See Guide 11) • Stage IB (T1b [<0.8 mm thick with ulceration or 0.8–1.0 mm thick ± ulcertaion]) • Wide excision ª • Follow-up care (See Guide 11) • Wide excision with SLN biopsy ª • SLN negative ª • Follow-up care (See Guide 11) • SLN positive ª • See Guide 12 • Stage IB (T2a) • Stage II (>1.0 mm thick, any feature, N0) ª • Wide excision ª • SLN negative ª If Stage IB, IIA: • Observe If Stage IIB, IIC: • Observe • Interferon alfa • Wide excision with SLN biopsy ª • SLN positive ª • See Guide 12

RkJQdWJsaXNoZXIy MTE3MTE1