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Updated: Sep 3, 2025
Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
Published on: May 10, 2021
Association between excision margins and local recurrence in 1407 patients with primary in situ melanomas
Licata Gaetano1, Birra Domenico2, Serigne N Lo3,4
1Dermatology Unit- University of Campania "Luigi Vanvitelli", Naples, Italy.
Background:
Reliable evidence to guide the management of melanoma in situ (MIS) and minimize the risk of recurrence is lacking.
Objective:
To identify clinicopathological predictors of local recurrence (LR) in patients with MIS and evaluate long-term outcomes according to pathological excision margins.
Methods:
A case-control study of patients with MIS treated at a large Australian melanoma treatment center from January 2008 to December 2012 was undertaken. Clinicopathological characteristics of patients who developed LR and those who did not were compared.
Results:
LR developed in 34 of 1407 patients with MIS (2.5%). Median time to LR was 20 months. The primary lesion was removed with pathological margins <4 mm (P < .001) in 67.6 % of patients with LR. Four patients died of metastatic melanoma following LR. Comparing patients with pathological margins <4 mm and ≥4 mm, the former were older (>60y, P < .001), more frequently had MIS on the head or neck (P < .001), had a greater LR rate (P < .001), and had a higher mortality from all causes (P < .001).
Limitations:
Retrospective, single-institution study.
Conclusions:
Pathological margins of ≥4 mm should be considered for patients with MIS who are treated with standard surgical excision and assessed by examining serial slices taken from the formalin-fixed, paraffin-embedded specimen.
