This protocol covers the management of patients with localised cutaneous melanoma at the primary site, with no regional lymph node involvement and no distant spread — corresponding to pT1b–pT4b cN0 cM0 disease.
The patient has localised cutaneous melanoma confined to the primary tumour. There is no evidence of regional lymph node metastasis and no distant metastasis (cN0 cM0). The clinical algorithm addresses this staging category specifically.
In carefully selected patients, definitive radiotherapy targeting the primary site is one approach that may be considered for local control. The structured protocol defines the precise selection criteria and the complete management pathway — see the full regimen below.
Proposed algorithm for the management of patients with pT1b-pT4b cN0 cM0 melanoma.
Definitive radiotherapy (RT) to the primary tumour can only be considered in carefully selected patients for local control when excision is not possible either due to severe patient comorbidities (e.g. very old age, end-stage cardiovascular disease, etc.), when the morbidity associated with the excision is considered unacceptable or when surgery is refused by the patient.
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