Narrow-Margin Excision for Invasive Acral Melanoma: Is It Acceptable?

Area of Science:

• Dermatology
• Surgical Oncology

Background:

• Acral melanoma is an infrequent but aggressive skin cancer.
• Optimal surgical margins for acral melanoma remain debated.

Purpose of the Study:

• To evaluate the safety and efficacy of narrow-margin excision versus National Comprehensive Cancer Network (NCCN)-recommended margins for primary invasive acral melanoma.

Main Methods:

• Retrospective review of 100 patients with acral melanoma.
• Comparison of outcomes between narrow-margin (N-group) and NCCN-recommended margin (R-group) excision.
• Analysis of margin status, recurrence, mortality, and survival rates.

Main Results:

• Local recurrence and positive margins were rare for both groups.
• Similar mortality rates for T1-3 melanomas in both groups.
• Higher mortality observed in T4 melanoma patients treated with narrow margins compared to R-group.
• Breslow thickness, not surgical margin, was an independent risk factor for survival.

Conclusions:

• Narrow-margin excision may be safe for early-stage acral melanoma but poses higher risks for T4 tumors.
• Current NCCN guidelines for surgical margins should be followed.
• Prospective data collection is needed to better define acral melanoma prognosis.