title: The operative management of melanoma: where does Mohs surgery fit in?
abstract: 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.
authors.affiliation: Division of Dermatological Surgery, Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
authors.forename: Kyung Hee
authors.initials: KH
authors.lastname: Chang
authors.forename: Raymond
authors.initials: R
authors.lastname: Dufresne
authors.forename: Antonio
authors.initials: A
authors.lastname: Cruz
authors.forename: Gary S
authors.initials: GS
authors.lastname: Rogers
mesh_terms: D006801:Humans; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D015580:Mohs Surgery; D017410:Practice Guidelines as Topic; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*