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

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Deep Margins Melanoma: How Deep Is Deep Enough?

Megan L Burger¹, James M Haggerty¹, Shengxuan Wang¹

¹Department of Surgical Oncology, Geisinger Wyoming Valley, Wilkes Barre, PA, USA.

The American Surgeon

|December 19, 2022

Summary

This summary is machine-generated.

Wide excision (WE) for invasive melanoma to muscular fascia may not be necessary. Excision depth and biopsy type did not impact recurrence risk, suggesting simpler techniques may suffice for melanoma treatment.

Keywords:

biopsy margins melanoma recurrence wide excision

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A Robust Discovery Platform for the Identification of Novel Mediators of Melanoma Metastasis

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Published on: March 8, 2022

Area of Science:

Dermatology
Surgical Oncology
Cancer Research

Background:

Wide excision (WE) to muscular fascia is a common practice for invasive melanoma.
Excision to subcutaneous tissue may be sufficient, but practice patterns and recurrence risks are not fully understood.

Purpose of the Study:

To evaluate practice patterns regarding biopsy and excision depth for invasive melanoma.
To assess the relationship between biopsy/excision techniques and melanoma recurrence risk.

Main Methods:

Retrospective review of 385 patients with pT1-4 melanoma (cN0) treated with WE.
Analysis of patient factors, biopsy techniques (shave, excisional, punch, incisional), excision depths (muscular fascia vs. subcutaneous fat), and recurrence data.

Main Results:

385 patients (2006-2020) with melanoma on extremity, head/neck, or trunk were analyzed.
Deep biopsy margins were positive for melanoma in situ in 139 patients.
51 patients experienced recurrence (locoregional, distant, or new lesions).

Conclusions:

Older age and female gender were associated with recurrence.
Trunk location, superficial spreading melanoma, ulceration, perineural invasion, and advanced T/P stage correlated with recurrence.
While patients with recurrence were more likely to have WE to muscular fascia, biopsy type and dissection depth were not associated with recurrence risk.