This protocol applies to patients with localised cutaneous melanoma confined to the primary tumour site, with no regional lymph node involvement (cN0) and no distant metastasis (cM0).
The primary intervention is surgical: wide local excision (WLE) of the primary tumour. Safety margins are determined by tumour-specific characteristics, and specific modifications may apply for particular anatomical sites. The complete margin criteria, modification rules, and procedural details are set out in the full protocol.
Proposed algorithm for the management of patients with pT1b-pT4b cN0 cM0 melanoma.
Full depth, wide local excision (WLE) of primary tumours (with safety margins of 0.5 cm for in situ melanomas, 1 cm for tumours with a thickness of 2 mm and 2 cm for tumours thicker than 2 mm) is recommended.
Modifications, with reduced safety margins, or micrographic surgery, are acceptable for preservation of function in acral and facial melanomas, including lentigo maligna melanoma.
Full depth, WLE of primary tumours with safety margins of 0.5 cm for in situ melanomas, 1 cm for tumours with a thickness 2 mm and 2 cm for tumours >2 mm is recommended [III, B].
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