“What's New” in Management of Cutaneous Malignant Melanoma CMM and Its Oncological Lymphatic Pathology: A Southern Hemisphere Perspective

Introduction: The incidence rate (IR) of malignant melanoma (MM) (35/100,000) in the year 2000 in ANZ is amount to the highest in the world. There are over 13,000 new cases and 1,750 deaths in recent years. In the United States, MMs are the 3rd most common cancer in men and 4th in women. MM is the 6th most common cancer and > 10,000 new cases were diagnosed and identified as cause of 6,850 deaths in 2020. The IR increased by 15-fold in 40 years period and registered the highest cancer specific MR rise in men age > 65 years. Head and neck melanoma will account for nearly 30%. The incidence and mortality rate (MR) of cutaneous malignant melanoma has been increasing in recent decades in all parts of the world. The global total tally is > 300,000 cases and > 60,000 deaths. Countries have population of predominantly Celtic stock with Fitzpatrick Type 1–2 skin which is subjecting to increasing high level UVR exposure are at great risk.

Presentation: Broadly speaking, there are five groups of factors affecting delivery of safe surgery decision making, namely, medical condition, information, institutional, patient and surgeon domains. Globally in the domain of information, a shortfall of systemic analysis on local clinical information database will highlight the importance of re-evaluating and prioritizing algorithm in surgical management. It is pertinent to have robust clinical guidelines and Class 1 evidence-based recommendations. This will also provide a solid base for safe surgery delivery. With this outset in mind, the latest innovations in cMM will make a very significant impact on the surgical management of primary cMM in head and neck region. Contemporary surgical care consideration will include, first, update on knowledge and application of international MM staging (AJCC 7 and 8th editions, 2018) into treatment of primary cMM; second, understanding of its role in determining sentinel lymph node biopsy (SLNBx) and subsequent consideration in different lymph node dissection strategies, including completion CLND, selective LND, elective LND and therapeutic LND, and, finally know and aware of “what's new” in head and neck cMM management.

Conclusion: The relevance of what's new in latest innovation in cMM has been discussed including SLNBx and different LNDs. Targeted therapies base on different oncological-genetic pathways will be explored as an adjunctive treatment in head and neck cMM.

Publication History

Article published online:
15 February 2022