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Narrow resection of cutaneous melanoma
1Division of Plastic Surgery, Department of Surgery, Queen's University, Kingston, Ontario, Canada.
Background:
There has been a progressive reduction in the extent of resection of primary cutaneous melanoma. Although overall survival appears to have been unaffected by this trend, the effect of narrow resection on local recurrence is not entirely clear.
Objective:
To examine the relationship between narrow resection margins and local recurrence of primary cutaneous melanoma.
Methods:
Primary melanoma, 104 cases, treated by surgical resection were reviewed retrospectively.
Results:
"Thin" (< 1 mm) melanomas (31 cases) were resected with a mean margin of 0.87 cm; "intermediate" (1-4 mm) melanomas (37 cases) were resected with a mean margin of 1.26 cm; and 14 "thick" (> 4 mm) melanomas were resected with a mean margin of 1.25 cm. Local recurrence rates were 6.5%, 16.2%, and 42.9%, respectively. In the "intermediate" group, two local recurrences occurred in melanomas < 2 mm thick despite use of margins of 1.7 cm and 2.4 cm.
Conclusions:
The results to not support the use of excessively narrow resection margins around primary cutaneous melanoma. Additionally, we question the true safety of currently accepted 1 to 2 cm margins for 1 to 2 mm thick melanomas.