Marginal Gain

Long-term comparison of wide versus narrow excision margins for thicker cutaneous melanomas confirmed higher mortality with 1-cm margins.

Margin control for the surgical treatment of primary melanoma is one of the more uniform practices in melanoma management. One slightly controversial area is the comparative merit of 3-cm excision margins versus 1-cm margins in melanomas thicker than 2 mm. An earlier study found higher rates of locoregional relapse among patients treated with 1-cm margins compared with 3-cm margins. Now, these same investigators report results of a long-term survival analysis of that trial, using the primary endpoints of overall and melanoma-specific survival.

Nine hundred patients with a single melanoma sited on the trunk or limbs and thicker than 2 mm were randomized to surgery with either a 1-cm or a 3-cm total excision margin. During a median follow-up o…

Reviewing Author

Hensin Tsao, MD, PhD

Disclosures

Consultant / advisory board Lubax; WorldCare Clinical

EquityLubax

Grant / Research support NIH; Department of Defense; American Skin Association; Piramal

Editorial boardsBritish Journal of Dermatology; Journal of the American Academy of Dermatology; Journal of Investigative Dermatology

Leadership positions in professional societies American Academy of Dermatology (Chair, Skin Cancer and Melanoma Committee); American Board of Dermatology (Director)