National Institutes of Health Consensus Development Conference Statement on Diagnosis and Treatment of Early Melanoma, January 27-29, 1992.

The National Institutes of Health Consensus Development Conference on Diagnosis and Treatment of Early Melanoma brought together experts in dermatology, pathology, epidemiology, public education, surveillance techniques, and potential new technologies, as well as other health care professionals and the public, to address (a) the clinical and histological characteristics of early melanoma; (b) the appropriate diagnosis, management, and follow-up of patients with early melanoma; (c) the role of dysplastic nevi and their significance; and (d) the role of education and screening in preventing melanoma morbidity and mortality. Following 2 days of presentations by experts and discussion by the audience, a consensus panel weighted the evidence and prepared a consensus statement. The panel agreed (a) that melanoma in situ is a distinct entity that can be treated effectively by surgery with 0.5-cm margins and that thin, invasive melanoma < 1 mm thick has the potential for long-term survival in < 90% of patients after surgical excision with a 1-cm margin; (b) that elective lymph node dissections and extensive staging evaluations should not be recommended in early melanoma; (c) that patients with early melanoma are at low risk for relapse but may be at high risk for development of subsequent melanomas and therefore should be followed closely; (d) that some family members of patients with melanoma are at increased risk for melanoma and therefore should be enrolled in surveillance programs; and (e) that education and screening programs have the potential to decrease morbidity and mortality from melanoma. The full text of the consensus panel's statement follows.