Improving outcomes for people with skin tumours including melanoma

Improving Outcomes for
People with Skin Tumours
including Melanoma
Organisation of skin
cancer services
Table 4. Patients for review by SSMDTs
• Patients referred from the LSMDT
• Patients with high-risk SCCs (see ‘Glossary of terms’,
Appendix 6) that pose difficulty in management
• Patients with MM managed by other site specialist teams
(e.g. gynaecological, mucosal and head and neck (excluding
ocular))
• Patients newly diagnosed with MM stage 2B or higher
(American Joint Committee on Cancer (AJCC) staging
system) 26
3
• Patients with MM stage 1 or above who are eligible for
clinical trials that have been approved at cancer network
level
• Patients with multiple MM
• Children younger than 19 years with MM
• Any patient with metastatic MM or SCC diagnosed at
presentation or on follow-up
• Patients with giant congenital naevi where there is suspicion
of malignant transformation
• Patients with BCCs that are metastatic
• Patients with malignant skin lesions of uncertain pathological
diagnosis
• Patients with rare skin cancers, including lymphoma and
sarcoma (see chapter on ‘Management of special groups’)
• For periodic review, patients developing skin cancers who
are immunocompromised, have Gorlin’s syndrome or other
genetic predisposition syndromes (see chapter on
‘Management of special groups’)
• Patients needing nodal dissection including sentinel lymph
node biopsy (SNB) – these patients should be seen and
referred by the LSMDT
• Patients who may benefit from radiotherapy, if not available
at the LSMDT
• Patients who may be eligible for entry into clinical trials
• Patients who require adjuvant treatment (where this is
shown to be beneficial)
26 American Joint Committee on Cancer (1992) Manual for staging of cancer. Philadelphia:
JB Lippincott.
58
National Institute for Health and Clinical Excellence