NCCN Quick Guide™ | Melanoma

NCCN Quick Guide™ | Melanoma

2 of 2 NCCN QUICK GUIDE tm Melanoma, 2018 PAT-N-1028-1217 What are the main treatment options for local melanoma? Stage 0 and IA � Wide excision 55 Stage IB and II � Wide excision � Wide excision with SLN ( s entinel l ymph n ode) biopsy What are the main treatment options for regional melanoma? Stage IIIA, IIIB, and IIIC � Active lymph node basin surveillance � Complete lymph node dissection 61 Clinical Stage III � Wide excision of primary tumor + complete therapeutic lymph node dissection Stage III clinical satellite or in- transit � Systemic therapy � Complete surgical excision to clear margins if possible � T-VEC ( t alimogene laherparep vec ), BCG ( B acillus C almette- G uerin), interferon alfa, or IL-2 ( i nter l eukin- 2 ) injection in tumor � Imiquimod cream � Consider radiation therapy if can’t be removed by surgery � Isolated limb infusion/ perfusion with melphalan What are the options for melanoma that returns near the first tumor? True local scar recurrence (persistent disease) � Remove more tissue from the tumor site (for clear margins) � Possible lymph node mapping and SLN biopsy 66 Local, satellite, and/ or in-transit recurrence � Systemic therapy � Complete surgical excision to clear margins if possible � T-VEC, BCG, interferon alfa, or IL-2 injection in tumor � Local ablation therapy � Imiquimod cream � Consider radiation therapy if can’t be removed by surgery � Isolated limb infusion/ perfusion with melphalan What are the treatment options for metastatic melanoma? Limited stage IV � Surgery, then observation, nivolumab, or treat as widespread � Systemic therapy, then observe, nivolumab, surgery, or treat as widespread 72 Widespread stage IV � First, surgery and/ or radiation for brain metastases � Systemic therapy � T-VEC injection into tumor � Palliative surgery or radiation � Best supportive care or palliative care NCCN Guidelines for Patients ® Page Number Ü NCCN.org/patients - for Patients | NCCN.org - for Clinicians The NCCN QUICK GUIDE tm series and NCCN Guidelines for Patients ® are supported by charitable donations made to the NCCN Foundation ® . For more details and the full library of patient and caregiver resources, visit NCCN.org/patients. DONATE NOW NCCNFoundation.org/Donate

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