Melanoma

Melanoma is a common aggressive skin cancer. Its numerous genetic mutations have become rich targets for systemic therapy with chemotherapy or immunotherapy. Surgery is the best initial treatment. Completion nodal dissection for sentinel node positive patients decrease regional occurrence but no survival benefit was found in a few studies. Radiotherapy (RT) is used as primary, adjuvant and palliative treatment. Specific scenarios with unknown primary, head and neck melanomas, and distant metastases are discussed. Systemic therapy includes molecular therapy based on diver mutation or immunotherapy. Treatment guidelines should be utilized by the multidisciplinary team to aid treatment decision making. Future improvement in outcome can only be achieved by enrollment of patient into clinical trials and therefore should be encouraged. Future research will be along the line of immunotherapy, target therapy, hyperthermia, nanoparticles, neutron, and radioisotope treatments.