Personalized new (one step) surgery options for cutaneous melanoma patients: facts and controversies

Abstract

The differences in standardized and personalized surgical treatment of cutaneous melanomas lie in the number of surgical interventions performed, each of the mentioned methodologies relying on different basic criteria. The standard model of clinical management is always performed within two surgical sessions, whereas the personalized one-step approach creates the prerequisites for a more sparing single surgical manipulation, providing a number of advantages for patients. The choice of one approach over the other relies both on the patient’s characteristics and the professional view of the clinician, tailored largely to the patients’ wishes. Because guidelines are recommended but not mandatory, heterogeneous surgical approaches in practice are a good solution, an opportunity for optimization, and a hope for more optimal postoperative outcomes concerning overall survival and the development of recurrences. This article analyzes the positive aspects of personalized single-stage melanoma surgery, comparing it with standard recommendations for surgical treatment of melanomas according to AJCC/EJC and ASCO. Personalized single-stage melanoma surgery achieves the same endpoints as the AJCC/EJC and ASCO criteria for surgical treatment of cutaneous melanomas, but the latter is achievable within two surgical sessions.