The operative management of melanoma: where does Mohs surgery fit in?

Dermatol Surg. 2011 Aug;37(8):1069-79. doi: 10.1111/j.1524-4725.2011.02005.x. Epub 2011 May 17.


Background: Melanoma is a life-threatening malignancy. Surgery is the primary management for melanoma, and management guidelines have evolved gradually over a century from radical surgery with lymph node dissection to conservative margin surgery. There are specific rationales and problems with Mohs micrographic (MMS) surgery for managing melanoma.

Objective: To review the literature for the surgical management of melanoma and to understand where MMS fits in this spectrum of management options.

Conclusions: MMS should be considered as an option for melanoma surgery, especially when the tumor is found in photodamaged skin. Further randomized prospective clinical trials are needed to select the best therapeutic approach for the treatment of melanoma. Until then, careful margin control is the key for successful tumor removal whether it is standard excision, staged excision, or MMS.

Publication types

  • Review

MeSH terms

  • Humans
  • Melanoma / pathology
  • Melanoma / surgery*
  • Mohs Surgery*
  • Practice Guidelines as Topic
  • Skin Neoplasms / pathology
  • Skin Neoplasms / surgery*