Editing Melanoma (section)

== '''Recurrence''' ==

* Local recurrence
** Defined as recurrence within 5cm of WLE scar or skin graft
** Aggressive tumour biology and poor prognosis
**

{| class="wikitable"
|Breslow
|Recurrence risk
|-
|<0.75
|0.2%
|-
|0.75-1.5
|2%
|-
|1.5-4
|6%
|-
|>4
|13%
|}

** Resect to histologically clear margins; aim for 1cm margins and complete resection of scar
** SLNB technically feasible, and often useful information
* Recurrent in-transit disease
** Intralesional and systemic therapy
* Regional node recurrence
** After confirming absence of metastatic disease, perform a therapeutic dissection (above) and then adjuvant immunotherapy
** Can also recognise that many of these patients will have systemic metastases too, and consider neoadjuvant immunotherapy followed by assessment of response and subsequent therapeutic dissection