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Optimal resection margin for cutaneous malignant melanoma.

D E Elder, D Guerry, R M Heiberger

    Plastic and Reconstructive Surgery
    |January 1, 1983
    PubMed
    Summary
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    Wide local excision for cutaneous malignant melanoma is effective for thick tumors, preventing recurrence. Modest margins are suitable for thin melanomas, as survival is not margin-dependent.

    Area of Science:

    • Dermatology
    • Surgical Oncology

    Background:

    • Wide local excision with a 5-cm margin is the traditional treatment for cutaneous malignant melanoma.
    • The rationale for this wide margin has not been clearly defined, though it is known to prevent local recurrence.

    Purpose of the Study:

    • To investigate the relationship between excision margin width and outcomes in melanoma patients.
    • To determine if margin width impacts local recurrence, metastasis, or survival.

    Main Methods:

    • A retrospective study of 105 patients with 109 primary melanomas treated in 1977.
    • Analysis correlated excision margin width with satellitosis, local recurrence, in-transit metastases, and survival.

    Main Results:

    • No local recurrences were observed, irrespective of margin width.

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  • Survival was not dependent on the width of the local excision margin.
  • Satellitosis and in-transit metastases, indicators of recurrence potential, were only observed in melanomas thicker than 2.0 mm (Breslow depth).

    • Conclusions:

    • Wide excision is justified for thick melanomas (>2.0 mm Breslow depth) due to their potential for local recurrence.
    • More conservative local therapy may be appropriate for thin cutaneous melanomas.