Margins for Melanoma: Extent of Resection, Alternative Approaches, and Future Considerations

Melanoma surgical margins have undergone significant evolution over the past century. Wide local excision (WLE) remains the established standard-of-care for localized cutaneous melanoma and guidelines have been established via multiple randomized-controlled trials (RCTs). Mohs micrographic surgery (MMS) has gained popularity in the past 2 decades, and while data are promising with regards to recurrence rates and survival, the data remain largely retrospective. MMS is not currently recommended for invasive melanoma where standard WLE margins are feasible. Future RCTs assessing narrower margins will offer insight into long-term oncologic outcomes as well as improved postoperative recovery after WLE.