The Skin

Primary cytotoxic therapy and/or radiotherapy have not been shown to improve outcome in patients with melanoma. Of note neoadjuvant therapy (i.e. chemotherapy and radiotherapy prior to surgical excision) has been shown to confer substantial benefits in

• Esophageal cancer, both squamous and adenocarcinoma (better for squamous)
• T3 adenocarcinoma of the rectum

The best exicision margin for patients with melanoma depends on the thickness of the tumour.

Thickness	Margin
< 1 mm	1 cm
1.1 - 2 mm	2 cm
2.1 - 4 mm	?
> 4 mm	?