Management of melanoma.

Background: Melanoma is a potentially curable cancer, but around 20% of patients will develop disease which is beyond surgical clearance. Rising incidence alongside breakthroughs in understanding the molecular biology of this disease identifying systemic therapies offering survival gains now demand amore proactive, integrated approach to melanoma management. Sources of data: PubMed references relating to aspects of melanoma research and treatment. Areas of agreement: Rapidly rising incidence throughout the world. Effective surgery as well as new molecular targeted systemic biological agents and immunotherapies necessitating early diagnosis and multidisciplinary therapeutic interventions. Areas of controversy: Role of screening and prevention. Benefit of interventions for locoregional melanoma, including role of sentinel lymph node biopsy. Integration and sequencing of treatments for unresectable melanoma. Growing points: Molecular determinants of melanoma influencing disease outcome and treatment decisions. Areas timely for developing research: Education and training of patient and healthcare professionals. Role of screening, surveillance and follow-up strategies. Biology of melanoma guiding treatment decisions.