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Patient Derived Cell Culture and Isolation of CD133+ Putative Cancer Stem Cells from Melanoma
Published on: March 13, 2013
Excision margins in high-risk malignant melanoma.
J Meirion Thomas1, Julia Newton-Bishop, Roger A'Hern
1Royal Marsden Hospital National Health Service Trust, London, United Kingdom.
The New England Journal of Medicine
|February 20, 2004
Summary
For thick melanomas (≥2 mm), a 1-cm excision margin increases locoregional recurrence risk compared to a 3-cm margin. However, overall survival rates remain similar between the two surgical margin groups.
Area of Science:
- Oncology
- Surgical Oncology
- Dermatology
Background:
- Debate persists regarding optimal surgical excision margins for cutaneous melanoma.
- Melanoma thickness of 2 mm or greater is considered a poor prognostic indicator.
Purpose of the Study:
- To compare the efficacy of 1-cm versus 3-cm surgical margins for excision of cutaneous melanoma.
- To evaluate the impact of margin size on locoregional recurrence and overall survival.
Main Methods:
- A randomized clinical trial was conducted involving 900 patients with melanoma.
- Patients were randomized to undergo surgery with either a 1-cm or 3-cm margin of excision.
- Median follow-up was 60 months.
Main Results:
- A 1-cm margin was associated with a significantly increased risk of locoregional recurrence (hazard ratio, 1.26; P=0.05).
- There were more locoregional recurrences in the 1-cm group (168) versus the 3-cm group (142).
- Overall survival rates were similar between the 1-cm and 3-cm margin groups (hazard ratio for death, 1.07; P=0.6).
Conclusions:
- For melanomas with a tumor thickness of at least 2 mm, a 1-cm margin of excision leads to a higher risk of regional recurrence compared to a 3-cm margin.
- Despite the increased recurrence risk, overall survival rates were comparable between the two margin groups.
