Narrow surgery for primary melanoma is required to preserve function and esthetics to acquire prognostic information to program subsequent treatment. Sentinel lymph node biopsy confirmed a survival benefit for patients who had early stage III disease. Analyses of factors within sentinel node reflect the biologic behavior of the tumor and may separate out patients who may or may not need additional locoregional and/or systemic therapy. Radical lymph node dissection is mandatory for stage III disease. Electrochemotherapy for in-transit disease and cutaneous distant metastases as novel approach. Surgery of stage IV disease improves overall survival in selected patients.
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