The incidence of melanoma in the United States has been increasing over the past several decades. Prognosis largely depends on disease stage, with 5-year melanoma-specific survival ranging from as high as 99% in patients with stage I disease to less than 10% for some patients with stage IV (distant metastatic) disease. Fortunately, in the last 5–10 years, there have been remarkable treatment advances for patients with high-risk resectable melanoma, including approval of targeted and immune checkpoint blockade therapies. In addition, results of recent clinical trials have confirmed the importance of sentinel lymph node biopsy and continue to refine the approach to regional lymph node basin management. Lastly, the melanoma staging system was revised in the eighth edition AJCC Cancer Staging Manual, which was implemented on January 1, 2018. Here we discuss these changes and the clinicopathological features that confer high risk for locoregional and distant disease relapse and poor survival. Implications regarding the management of melanoma in the metastatic and adjuvant settings are discussed, as are future directions for neoadjuvant therapies.

中文翻译：

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高危可切除黑色素瘤的临床病理特征，分期和当前治疗方法。

在过去的几十年中，美国黑色素瘤的发病率一直在上升。预后很大程度上取决于疾病的阶段，五年期黑色素瘤特异性生存率从I期疾病患者的高达99％到某些IV期（远处转移）疾病的患者的不到10％不等。幸运的是，在过去的5-10年中，针对高危可切除黑色素瘤患者的治疗取得了显着进展，包括批准了靶向和免疫检查点封锁疗法。此外，最近的临床试验结果证实了前哨淋巴结活检的重要性，并继续完善区域淋巴结流域管理的方法。最后，在第八版AJCC癌症分期手册中对黑素瘤分期系统进行了修订，于2018年1月1日实施。在这里，我们讨论了这些变化以及赋予局部和远处疾病复发高风险和不良生存的临床病理特征。讨论了有关转移性和辅助性黑色素瘤治疗的意义，以及新辅助治疗的未来方向。