Melanomas 076399 mm Thick Intermediate

• Single-Modality Therapy: excision with 2 cm margin down to fascia

• Adjuvant Therapy: may consider interferon a-2b (see next page)

• N0 Neck: may consider sentinel lymph node biopsy (see below), if positive should complete a neck dissection (posterior lateral neck

Table 5—2. Melanoma 5-Year Survival and Metastasis Potential Based

on

Pathological Staging

Stage

5-Year Survival

Nodal Metastasis

Distant Metastasis

pTi

>95%

2-3%

PT2

80-94%

20-25%

8%

PT3

40-84%

57%

15%

PT4

10-30%

62%

72%

dissections may be considered for scalp lesions); Intergroup Melanoma Surgical Program revealed an overall

5-year survival benefit with elective neck dissections for patients <60 years old with 1—2 mm melanomas, especially for tumors without ulcerations (Ann Surg. 1996; 224:255-266)

• Nt_3 Neck: neck dissection (may require a superficial parotidectomy), may consider chemotherapy

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