Melanoma recurrence after excision. Is a wide margin justified?

Area of Science:

• Dermatology
• Surgical Oncology

Background:

• Stage I melanoma treatment involves surgical intervention.
• Optimal surgical margins and closure techniques are debated.

Purpose of the Study:

• To evaluate the impact of surgical intervention degrees on outcomes for stage I melanoma.
• To compare recurrence rates and wound complications based on excision margins and closure methods.

Main Methods:

• Retrospective analysis of 187 patient records (1975-1989).
• Categorization of lesions into thin, intermediate, and thick.
• Comparison of outcomes based on excision margin width, initial excision vs. re-excision, and primary closure vs. grafting.

Main Results:

• No significant difference in recurrence rates was observed between narrower (≤15 mm) and wider excision margins.
• No significant difference in recurrence rates between initial excision and wider re-excision.
• No significant difference in recurrence rates between primary closure and grafting.
• Significantly higher wound complication rates with grafting (31%) compared to primary closure (6%) (p < 0.01).

Conclusions:

• Conservative excision margins (1.00-1.50 cm) are advocated for stage I melanoma.
• Primary wound closure is preferred to minimize complications.
• Surgical intervention degrees studied did not significantly impact melanoma recurrence rates.