Malignant melanoma: management guidelines.

The incidence of primary melanoma of the skin, once rare, has been increasing rapidly over the past few decades. Although it accounts for only 3% of all primary cutaneous malignancies, melanomas are responsible for two thirds of skin cancer-related deaths. Fortunately, early detection and surgical removal have resulted in a concomitant improvement in overall survival. Ongoing clinical trials are addressing various therapeutic alternatives, as well as whether any treatment modality will significantly increase response rates and survival in patients with advanced disease. These prospects are discussed, and current prognostic factors and available therapies reviewed.