Surgical excision of melanoma

Surgery Overview

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Surgery to remove (excise) a melanoma removes the entire melanoma along with a border (margin) of normal-appearing skin. The width of the border of normal skin removed depends on the depth of the melanoma. Additional tissue, usually skin and fat, is also removed from under the melanoma.

• Small excisions may be closed with stitches and heal without problems.
• Large excisions or those located on the hands, face, or feet may require a skin graft to close the wound after surgery.

The type of anesthetic used for your surgery depends on the size and location of the melanoma. Surgery on small, easily reached melanomas may require only a local anesthetic, while surgery for larger melanomas may require general anesthesia.

• Melanoma
• Area of excision
• Postoperative appearance

What To Expect After Surgery

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Recovery after surgery to remove a melanoma depends upon the site and extent of surgery. The wound may take longer to heal if reconstructive surgery techniques such as skin grafts are used.

Why It Is Done

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The type of surgery that is done depends on the stage of the melanoma.

• Primary melanoma (melanoma in situ or stage I or II cancer) is treated with surgical excision of the lesion. If the melanoma is thin and has not deeply invaded surrounding healthy tissues, completely removing it usually cures the cancer.
• Stage III primary melanoma with lymph node involvement is treated with surgery to remove the primary melanoma and lymph nodes in the region of the primary melanoma.
• The goal of treatment for metastatic melanoma (stage IV) is to relieve symptoms and prolong life. It does not usually cure the cancer.

How Well It Works

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Surgery to remove the primary melanoma usually cures melanoma in situ and stage I cancer. It often cures stage II cancer (local spread of melanoma). It may cure the cancer or extend survival rates for stage III cancer if the lymph nodes are also removed.¹

Surgery provides the most effective and longest-lasting relief of symptoms of, but rarely cures, metastatic melanoma.

Risks

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Risks of surgery to remove melanoma include:

• Infection.
• Scarring.
• Bleeding.
• Rejection of skin graft.

What To Think About

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In some cases a sentinel node biopsy is performed before or during surgical excision of a melanoma.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

References

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Citations

1. Kanzler MH, Mraz-Gernhard S (2001). Treatment of primary cutaneous melanoma. JAMA, 285(14): 1819–1821.

Credits

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Author	Shannon Erstad, MBA/MPH
Editor	Kathleen M. Ariss, MS
Associate Editor	Denele Ivins
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Randall D. Burr, MD - Dermatology
Last Updated	January 11, 2007