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Cure depends on tumor stage, not time; lifelong skin surveillance is advised because of recurrence and new melanoma risk.","revision_rate_pct":{"min":2,"max":8,"unit":"percent","qualifier":"Re-excision for positive margins or later scar revision, or return to theatre for wound complications."},"scars":"Linear scar from elliptical excision, about three times as long as wide; size depends on tumor thickness and margin. Grafts or flaps leave larger scars. Scars mature over 6-12 months.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single excision visit; follow-up not counted. Sentinel node biopsy is additional, outside base scope."},"stages":[{"code":"wide_local_excision","label":"Wide local excision of the primary melanoma site with closure","after":{"min":14,"max":56,"unit":"days","qualifier":"Usually 2-8 weeks after diagnostic biopsy."}}],"qualifier":"Excision-only base protocol; reconstruction and nodal surgery are not included."},"success":{"metric":"Local recurrence-free after wide local excision","value":97,"unit":"percent","horizon":"5 years","population":"Adults with primary localized cutaneous melanoma (in situ or thin to intermediate thickness)","evidence_status":"limited"},"techniques":[{"name":"Wide local excision with primary closure","suits_whom":"Most primary melanomas, with margins set by Breslow thickness (generally 0.5-2 cm).","recovery":"Sutures removed in about 1-2 weeks; return to light activity in days."},{"name":"Wide local excision with skin graft or local flap reconstruction","suits_whom":"Larger defects or sites (face, acral, lower limb) where direct closure is not feasible.","recovery":"Longer healing and activity restriction; may require a longer stay."}],"treatment_conditions":["outpatient"],"treatment_duration_hours":{"min":0.5,"max":1.5,"unit":"hours","qualifier":"Primary closure under local anesthesia. Sentinel biopsy, reconstruction and nodal surgery excluded and take longer."},"initial_assessment_documents":["Biopsy histopathology report with Breslow thickness","Dermoscopy or clinical photos of the lesion site","Pathology slides or digital slide scan (if available)","Ultrasound or CT reports (if available)","Previous skin cancer or melanoma treatment records"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"Single excision; stay 10-14 days covers suture removal and margin pathology review. Second trip only for surveillance or further staging."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check that the surgeon has experience treating melanoma","scope":"procedure","source":{"url":"https://www.aad.org/public/diseases/skin-cancer/types/common/melanoma/after-diagnosed","host":"aad.org","quote":"The surgeon who performs this surgery is usually a surgical oncologist who has experience treating melanoma.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Check that the clinic provides pathology examination of removed tissue","scope":"procedure","source":{"url":"https://www.aad.org/public/diseases/skin-cancer/types/common/melanoma/diagnose-treat","host":"aad.org","quote":"The tissue that your dermatologist removes will be sent to a lab, where a doctor, such as a dermatopathologist, will examine it under a high-powered microscope.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check that sentinel lymph nodes can be tested when indicated to determine whether cancer has spread nearby","scope":"procedure","source":{"url":"https://www.aad.org/public/diseases/skin-cancer/types/common/melanoma/node-biopsy","host":"aad.org","quote":"Having a sentinel lymph node biopsy (SLNB) can tell whether cancer cells have spread to a nearby lymph node.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C4","text":"Check that the clinic can assess surgical margins for remaining cancer cells","scope":"procedure","source":{"url":"https://www.aad.org/public/diseases/skin-cancer/types/common/melanoma/after-diagnosed","host":"aad.org","quote":"The removed tissue will be checked to make sure that there are no remaining melanoma cells along the edges.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C5","text":"Ask for certification information and the name of the body that certified the surgical setting","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Ask for certification information and the name of the certifying body when assessing a surgical setting.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F2","text":"Forceful persuasion or cheap, time-limited offers pushing you into a quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably is.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Incision site opens up","urgency":"contact_clinic","general":false,"source":{"url":"https://melanomasurgery.ucsf.edu/sites/default/files/2023-09/ucsf-melanoma-and-skin-cancer-surgery-handout.pdf","host":"melanomasurgery.ucsf.edu","quote":"Your incision site opens up","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"W2","text":"Excessive drainage from the incision","urgency":"contact_clinic","general":false,"source":{"url":"https://melanomasurgery.ucsf.edu/sites/default/files/2023-09/ucsf-melanoma-and-skin-cancer-surgery-handout.pdf","host":"melanomasurgery.ucsf.edu","quote":"There is excessive drainage from the incision.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"W3","text":"Pain medication does not control pain","urgency":"contact_clinic","general":false,"source":{"url":"https://melanomasurgery.ucsf.edu/sites/default/files/2023-09/ucsf-melanoma-and-skin-cancer-surgery-handout.pdf","host":"melanomasurgery.ucsf.edu","quote":"The pain medication does not control your pain","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T2","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"Surgery is impractical or contraindicated for melanoma in situ","name":"Radiation therapy","source":{"url":"https://www.aad.org/member/clinical-quality/guidelines/melanoma","host":"aad.org","quote":"Nonsurgical approaches (imiquimod and traditional forms of radiation therapy) should only be considered if surgery is impractical or contraindicated, and only for melanoma in situ, lentigo maligna type, as the cure rates associated with these treatments are lower.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200},"operation_id":null}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"technique_details":{"status":"ok","items":[{"id":"wide-local-excision-with-primary-closure","name":"Wide local excision with primary 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