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Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way

Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way

Published on: May 10, 2021

Surgical excision margin for primary acral melanoma.

Kyeong-Tae Lee¹, Eun-Ji Kim¹, Dong-Youn Lee²

¹Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Journal of Surgical Oncology

|September 20, 2016

Summary

For thin acral melanoma (AM), a 1 cm excision margin is sufficient. A 2 cm margin improves local control for thick AM but does not improve survival outcomes.

Keywords:

acral melanoma excision margin local recurrence sentinel lymph node biopsy survival

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Area of Science:

Oncology
Surgical Oncology
Dermatology

Background:

Acral melanoma (AM) is a rare subtype of cutaneous melanoma.
Excision margin size is a critical factor in melanoma treatment.
Optimal margin for AM remains debated.

Purpose of the Study:

To evaluate the impact of excision margin size on treatment outcomes in acral melanoma.
To compare recurrence rates and survival for different margin sizes.

Main Methods:

Retrospective cohort study of 129 primary acral melanoma patients.
Analysis of recurrence rates, local and in-transit recurrence-free survival (LITRFS), disease-free survival (DFS), and melanoma-specific survival (MSS).
Comparison of outcomes based on excision margin size (>1 cm for thin AM, <2 cm vs. 2 cm for thick AM).

Main Results:

Thin AM (≤1 mm) showed no recurrence or mortality with >1 cm margins.
For thick AM (>1 mm), a 2 cm margin reduced local recurrence and LITR compared to <2 cm margins (P<0.05).
No significant differences in DFS or MSS were observed between margin groups for thick AM.

Conclusions:

A 1 cm excision margin is adequate for thin acral melanoma.
A 2 cm margin improves local control for thick acral melanoma but does not enhance overall survival.
Further research may explore adjuvant therapies for thick AM to improve survival outcomes.