Melanoma surgery

Reconstructive surgery

In the last few decades, the incidence of melanoma has been steadily growing; thus every 75th person born in the USA in 2000 is expected to develop melanoma. The annual incidence in Croatia has been increasing by 8%, which amounts to a difference of 310% compared to the period of 40 years ago. As melanoma is a type of cancer with a high metastatic potential, early detection is key to successful treatment. Numerous studies have shown that the growing percentage of melanoma patient survival observed in the last few decades is the result of early detection and appropriate surgical treatment. The high-risk population for this tumor are individuals with a pale complexion and light-colored eyes, individuals with multiple atypical nevi or large congenital nevi, individuals with a family history of atypical nevi, as well as persons with a history of three or more sunburns, especially those accompanied by the appearance of bullae.

The typical sites for the development of melanomas are the trunk in men and the lower extremities in women. The majority of melanomas (50-60%) arise from unchanged skin, whereas a smaller number of them develop from existing nevi which turn malignant. The earliest symptom is itching. Asymmetry, bleeding, discoloration, a diameter exceeding 6 mm, and a raised surface are clinical signs for the diagnosis of melanoma. This requires further surgical treatment: additional resection of the tissue surrounding the scar left after the first operation, as well as a biopsy of the first lymph node (sentinel node) which drains the area affected by the tumor. In the case of lymph node involvement, the removal of all lymph nodes of the affected pool is necessary. Systemic melanoma therapy is not very successful. The prognosis for melanoma is excellent in the case of shallow tumors which have not affected any lymph nodes.

In the presence of distant metastases, the prognosis is very poor.