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Melanoma resection margin recommendations, unconventionally based on available facts
1Department of Medicine, University of Washington School of Medicine, Seattle, USA.
Seminars in Diagnostic Pathology
|August 26, 1998
Summary
Wide resection margins for primary melanoma are not supported by evidence. Narrowing margins to 1 cm is safe and effective for invasive melanoma, regardless of thickness, based on extensive research.
Area of Science:
- Dermatology
- Surgical Oncology
Background:
- Historically, wide resection margins were standard for primary melanoma based on early 20th-century precedent.
- Empirical evidence supporting the efficacy of these wide margins was historically lacking.
Purpose of the Study:
- To evaluate the impact of narrowing resection margins on melanoma patient outcomes.
- To determine the optimal resection margin width for invasive melanoma.
Main Methods:
- Review of numerous retrospective analyses.
- Analysis of several prospective, randomized trials comparing different margin widths.
Main Results:
- Narrowing resection margins to 1 cm did not demonstrate an adverse effect on melanoma outcomes.
- Some nonrandomized studies indicated a slight increase in local recurrence with margins < 1 cm, particularly for thicker tumors.
Conclusions:
- The current evidence does not support the use of resection margins greater than 1 cm for invasive melanoma.
- A 1 cm resection margin is considered adequate for invasive melanoma of any thickness.