Melanoma skin cancer. A review of the literature.
Keywords:
Melanoma, cutaneous melanoma, clinical diagnosis, treatmentAbstract
Melanoma is a malignant tumor that originates in melanocytes and is the leading cause of skin cancer mortality. The most common form is cutaneous melanoma, which develops in the outermost layer of the skin. The objective of this study was to summarize the current evidence regarding considerations in the diagnosis and treatment of this neoplasia. To this end, a narrative review of the updated evidence on its diagnosis and treatment was conducted. Publications in databases such as Medline, Scielo, Tripdatabase, and Scopus were used as sources of information, based on a search strategy based on Mesh/Decs terms and Boolean operators. Current recommendations for diagnosis include detailed clinical evaluation, dermoscopy, and histopathological confirmation by biopsy. Regarding treatment, surgery remains the cornerstone, especially local resection with adequate margins. In advanced cases, lymphadenectomy and adjuvant therapies such as immunotherapy and, to a lesser extent, radiotherapy and chemotherapy are considered, although the latter have a limited role. In conclusion, a synthesis of the best updated evidence on the diagnosis and treatment of melanoma was provided, which will consolidate and update knowledge on diagnosis and treatment, given the complexity and heterogeneity of this disease. Furthermore, it emphasizes the importance of multidisciplinary approaches. This work contributes to improving clinical decision-making and promoting interventions for the prevention and early diagnosis of this neoplasia.
Downloads
References
Awada, G., & Neyns, B. (2022). Melanoma with genetic alterations beyond the BRAF V600 mutation: management and new insights. Current Opinion in Oncology, 34(2), 115-122. https://doi.org/10.1097/CCO.0000000000000817
Beal, B. T., Udkoff, J., Aizman, L., Etzkorn, J., Zitelli, J. A., Miller, C. J., Shin, T. M., Sobanko, J. F., & Brodland, D. G. (2023). Outcomes of invasive melanoma of the head and neck treated with Mohs micrographic surgery – A multicenter study. Journal of the American Academy of Dermatology, 89(3), 544-550. https://doi.org/10.1016/j.jaad.2022.12.038
Bloem, M., Van Not, O. J., Aarts, M. J. B., van den Berkmortel, F. W. P. J., Blank, C. U., Blokx, W. A. M., Boers‐Sonderen, M. J., Bonenkamp, J. J., de Groot, J. B., Haanen, J. B., Hospers, G. A. P., Kapiteijn, E. W., De Meza, M. M., Piersma, D., van Rijn, R. S., Stevense‐den Boer, M. A. M., Van der Veldt, A. A. M., Vreugdenhil, G., Van den Eertwegh, A. J. M., … Wouters, M. W. (2024). Adjuvant treatment with anti PD‐1 in acral melanoma: A nationwide study. International Journal of Cancer, 155(8), 1455-1465. https://doi.org/10.1002/ijc.35060
Boutros, A., Croce, E., Ferrari, M., Gili, R., Massaro, G., Marconcini, R., Arecco, L., Tanda, E. T., & Spagnolo, F. (2024). The treatment of advanced melanoma: Current approaches and new challenges. Critical Reviews in Oncology/Hematology, 196(2), 104-115. https://doi.org/10.1016/j.critrevonc.2024.104276
Brănișteanu, D. E., Porumb-Andrese, E., Stărică, A., Munteanu, A. C., Toader, M. P., Zemba, M., Porumb, V., Cozmin, M., Moraru, A. D., Nicolescu, A. C., & Brănișteanu, D. C. (2023). Differences and Similarities in Epidemiology and Risk Factors for Cutaneous and Uveal Melanoma. Medicina, 59(5), 943-952. https://doi.org/10.3390/medicina59050943
Bravo-Garzón, M. A., Bornstein-Quevedo, L., Camargo, V. P. de, Sanku, G., Jansen, A. M., Macedo, M. P. de, Rico-Restrepo, M., & Chacón, M. (2024). BRAF-Mutated Melanoma Journey in Latin America: Expert Recommendations From Diagnosis to Treatment. Cancer Control, 31. https://doi.org/10.1177/10732748241251572
Coit, D. G., Thompson, J. A., Albertini, M. R., Barker, C., Carson, W. E., Contreras, C., Daniels, G. A., DiMaio, D., Fields, R. C., Fleming, M. D., Freeman, M., Galan, A., Gastman, B., Guild, V., Johnson, D., Joseph, R. W., Lange, J. R., Nath, S., Olszanski, A. J., … Engh, A. M. (2019). Cutaneous Melanoma, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network : JNCCN, 17(4), 367-402. https://doi.org/10.6004/JNCCN.2019.0018
Cueva, P., & Yépez, J. (2019). Epidemiología del Cáncer en Quito 2011-2015. https://solcaquito.org.ec/wp-content/uploads/2022/05/Epidemiologia-del-cancer-en-Quito-2011-2015.pdf
Dixon, A. J., Sladden, M., Zouboulis, C. C., Popescu, C. M., Nirenberg, A., Steinman, H. K., Longo, C., Dixon, Z. L., & Thomas, J. M. (2024). Primary Cutaneous Melanoma—Management in 2024. Journal of Clinical Medicine, 13(6), 1607. https://doi.org/10.3390/jcm13061607
Eljilany, I., Castellano, E., & Tarhini, A. A. (2023). Adjuvant Therapy for High-Risk Melanoma: An In-Depth Examination of the State of the Field. Cancers, 15(16), 4125-4132. https://doi.org/10.3390/cancers15164125
Frech, F. S., Bommareddy, K., Hernandez, L., Dreyfuss, I., Urbonas, R., & Nouri, K. (2022). Cutaneous melanoma: An update on pathogenesis, prevention, and treatment. Dermatological Reviews, 3(6), 384-399. https://doi.org/10.1002/DER2.153
Garbe, C., Amaral, T., Peris, K., Hauschild, A., & Arenberger, P. (2022). European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment - Update 2022. European Journal of Cancer, 170(1), 256-284. https://doi.org/10.1016/j.ejca.2022.04.018
Garbe, C., Amaral, T., Peris, K., Hauschild, A., Arenberger, P., Basset-Seguin, N., Bastholt, L., Bataille, V., del Marmol, V., Dréno, B., Fargnoli, M. C., Forsea, A.-M., Grob, J.-J., Höller, C., Kaufmann, R., Kelleners-Smeets, N., Lallas, A., Lebbé, C., Lytvynenko, B., … Lorigan, P. (2022). European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics: Update 2022. European Journal of Cancer, 170(2), 236-255. https://doi.org/10.1016/j.ejca.2022.03.008
Gosman, L. M., Țăpoi, D.-A., & Costache, M. (2023). Cutaneous Melanoma: A Review of Multifactorial Pathogenesis, Immunohistochemistry, and Emerging Biomarkers for Early Detection and Management. International Journal of Molecular Sciences, 24(21), 158-167. https://doi.org/10.3390/ijms242115881
Guhan, S., Klebanov, N., & Tsao, H. (2021). Melanoma genomics: a state‐of‐the‐art review of practical clinical applications. British Journal of Dermatology, 185(2), 272-281. https://doi.org/10.1111/bjd.20421
International Agency for Research on Cancer. (2023). Mortality, Both sexes, in 2022 Melanoma of skin. https://gco.iarc.fr/today/en/dataviz/tables?mode=population&cancers=16&types=1
Javaid, A., Peres, T., Pozas, J., Thomas, J., & Larkin, J. (2025). Current and emerging treatment options for BRAFV600-mutant melanoma. Expert Review of Anticancer Therapy, 25(1), 55-69. https://doi.org/10.1080/14737140.2025.2451722
Kádár, Z., Lengyel, Z., & Gyulai, R. (2023). A melanoma malignum sebészeti ellátása – Elvárható standardok. Magyar Sebészet, 76(1), 39-47. https://doi.org/10.1556/1046.2023.10007
Lauters, R., Brown, A., & Harrington, K. (2024). Melanoma: Diagnosis and Treatment . Am Fam Physician, 110(4), 367-377. https://pubmed.ncbi.nlm.nih.gov/39418569/
Long, G. V, Swetter, S. M., Menzies, A. M., Gershenwald, J. E., & Scolyer, R. A. (2023). Cutaneous melanoma. The Lancet, 402(10400), 485-502. https://doi.org/10.1016/S0140-6736(23)00821-8
Lopes, J., Rodrigues, C., Gaspar, M. M., & Reis, C. P. (2022). Melanoma Management: From Epidemiology to Treatment and Latest Advances. Cancers, 14(19), 4652-4659. https://doi.org/10.3390/cancers14194652
Michielin, O., Van Akkooi, A. C., Ascierto, P. A., Dummer, R., & Keilholz, U. (2019). Cutaneous melanoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Annals of oncology : official journal of the European Society for Medical Oncology, 30(12), 1884-1901. https://doi.org/10.1093/ANNONC/MDZ411
Mooradian, M. J., & Sullivan, R. J. (2023). The case for adjuvant BRAF ‐targeted therapy versus adjuvant anti–PD‐1 therapy for patients with resected, high‐risk melanoma. Cancer, 129(14), 2117-2121. https://doi.org/10.1002/cncr.34806
Pathak, S., & Zito, P. M. (2023). Clinical Guidelines for the Staging, Diagnosis, and Management of Cutaneous Malignant Melanoma. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK572149/
Piñero-Madrona, A., Cerezuela-Fuentes, P., Ruiz-Merino, G., Martínez-Barba, E., Ortiz-Reina, S., Martínez-Ortiz, M. J., López-Ávila, A., Frías-Iniesta, J. F., Viney, A., & Cabezas-Herrera, J. (2023). Lower limb cutaneous melanoma surgery: location matters. Archives of Dermatological Research, 315(7), 1971-1978. https://doi.org/10.1007/s00403-023-02571-z
Rauwerdink, D. J., van Doorn, R., van der Hage, J., Van den Eertwegh, A. J. M., Haanen, J. B. A. G., Aarts, M., Berkmortel, F., Blank, C. U., Boers-Sonderen, M. J., De Groot, J. W. B., Hospers, G. A. P., de Meza, M., Piersma, D., Van Rijn, R. S., Stevense, M., Van der Veldt, A., Vreugdenhil, G., Wouters, M. W. J. M., Suijkerbuijk, K., ... Kapiteijn, E. (2022). Systemic Therapy in Advanced Nodular Melanoma versus Superficial Spreading Melanoma: A Nation-Wide Study of the Dutch Melanoma Treatment Registry. Cancers, 14(22), 5694. https://doi.org/10.3390/cancers14225694
Sergi, M. C., Filoni, E., Triggiano, G., Cazzato, G., Internò, V., Porta, C., & Tucci, M. (2023). Mucosal Melanoma: Epidemiology, Clinical Features, and Treatment. Current Oncology Reports, 25(11). https://doi.org/10.1007/S11912-023-01453-X
Shapiro, L., Basra, M., Patel, H., Payne, C., Brazen, B., & Biglione, A. (2024). Utilization of Imaging Modalities in the Diagnosis of Melanoma: A Scoping Review. Cureus, 16(2), 54-68. https://doi.org/10.7759/cureus.54058
Sun, W., Xu, Y., Qu, X., Jin, Y., Wang, C., Yan, W., & Chen, Y. (2023). Surgical resection margin for T3–T4 primary acral melanoma: a multicenter retrospective cohort study. Archives of Dermatological Research, 315(8), 2305-2312. https://doi.org/10.1007/s00403-023-02609-2
Swetter, S. M., Thompson, J. A., Albertini, M. R., Barker, C. A., Baumgartner, J., Boland, G., Chmielowski, B., DiMaio, D., Durham, A., Fields, R. C., Fleming, M. D., Galan, A., Gastman, B., Grossmann, K., Guild, S., Holder, A., Johnson, D., Joseph, R. W., Karakousis, G., Kendra, K., … Engh, A. M. (2021). NCCN Guidelines® Insights: Melanoma: Cutaneous, Version 2.2021. Journal of the National Comprehensive Cancer Network: JNCCN, 19(4), 364–376. https://doi.org/10.6004/jnccn.2021.0018
Swetter, S. M., Tsao, H., Bichakjian, C. K., Curiel-Lewandrowski, C., Elder, D. E., Gershenwald, J. E., Guild, V., Grant-Kels, J. M., Halpern, A. C., Johnson, T. M., Sober, A. J., Thompson, J. A., Wisco, O. J., Wyatt, S., Hu, S., & Lamina, T. (2019). Guidelines of care for the management of primary cutaneous melanoma. Journal of the American Academy of Dermatology, 80(1), 208–250. https://doi.org/10.1016/j.jaad.2018.08.055
Switzer, B., Puzanov, I., Skitzki, J. J., Hamad, L., & Ernstoff, M. S. (2022). Managing Metastatic Melanoma in 2022: A Clinical Review. JCO oncology practice, 18(5), 335–351. https://doi.org/10.1200/OP.21.00686
Tímár, J., & Ladányi, A. (2022). Molecular Pathology of Skin Melanoma: Epidemiology, Differential Diagnostics, Prognosis and Therapy Prediction. International Journal of Molecular Sciences, 23(10), 5384-5392. https://doi.org/10.3390/ijms23105384
Villani, A., Scalvenzi, M., Micali, G., Lacarrubba, F., Fornaro, L., Martora, F., & Potestio, L. (2023). Management of Advanced Invasive Melanoma: New Strategies. Advances in Therapy, 40(8), 3381-3394. https://doi.org/10.1007/s12325-023-02555-5
Waseh, S., & Lee, J. B. (2023). Advances in melanoma: epidemiology, diagnosis, and prognosis. Frontiers in Medicine, 10(2), 89-93. https://doi.org/10.3389/fmed.2023.1268479
Wollina U. (2022). Melanoma surgery-An update. Dermatologic therapy, 35(12), e15966. https://doi.org/10.1111/dth.15966
Żółkiewicz, J., Thomas, L., Kamińska-Winciorek, G., Pastuszak, K., Kunc, M., Maińska, U., Sobjanek, M., & Sławińska, M. (2025). Dermoscopy of External Ear Melanocytic Lesions: Performance of Selected Dermoscopic Screening Algorithms and Proposal of a New Predictive Model for Malignancy (AuriCheck Dermoscopic Algorithm). Cancers, 17(4), 679. https://doi.org/10.3390/cancers17040679
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Vicente Fernando Semanate-Zapata, Leonardo Daniel Manzano-Pasquel, Carlos Esteban Ochoa-Vinueza, Esteban Andrés Andrade-Sandoval, Sebastián Alejandro Montoya-Auz, Valeria Jacqueline Garófalo-Villalta
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish in Revista UGC agree to the following terms:
1. Copyright
Authors retain unrestricted copyright to their work. Authors grant the journal the right of first publication. To this end, they assign the journal non-exclusive exploitation rights (reproduction, distribution, public communication, and transformation). Authors may enter into additional agreements for the non-exclusive distribution of the version of the work published in the journal, provided that acknowledgment of its initial publication in this journal is given.
© The authors.
2. License
The articles are published in the journal under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0). The terms can be found at: https://creativecommons.org/licenses/by-nc-sa/4.0/deed.en
This license allows:
- Sharing: Copying and redistributing the material in any medium or format.
- Adapting: Remixing, transforming, and building upon the material.
Under the following terms:
- Attribution: You must give appropriate credit, provide a link to the license, and indicate if any changes were made. You may do this in any reasonable manner, but not in any way that suggests the licensor endorses or sponsors your use.
- NonCommercial: You may not use the material for commercial purposes.
- ShareAlike: If you remix, transform, or build upon the material, you must distribute your creation under the same license as the original work.
There are no additional restrictions. You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
