Excision

A randomized trial compared narrow margins (1 cm) with wide margins (≥3 cm) in 612 patients with melanomas no thicker than 2 mm.[1,2][Level of evidence A1]

A randomized trial compared narrow margins (1 cm) with wide margins (≥3 cm) in 612 patients with melanomas no thicker than 2 mm.[1,2][Level of evidence A1]

No difference was observed between the two groups in the development of metastatic disease, disease-free survival (DFS), or overall survival (OS).

A randomized trial compared narrow margins (1 cm) with wide margins (≥3 cm) in 612 patients with melanomas no thicker than 2 mm.[1,2][Level of evidence A1]

The risk of recurrence was 2.7% in patients with melanomas thicker than 1 mm who underwent narrow margins excision. No local recurrences occurred in the wider margin cohort.

A Swedish multicenter study included 989 patients with primary melanomas located on the trunk or extremities with a tumor thickness between 0.8 mm and 2 mm. Patients were randomly assigned to undergo wide excision with margins of either 2 cm (n = 476) or 5 cm (n = 513).[3][Level of evidence A1]

A Swedish multicenter study included 989 patients with primary melanomas located on the trunk or extremities with a tumor thickness between 0.8 mm and 2 mm. Patients were randomly assigned to undergo wide excision with margins of either 2 cm (n = 476) or 5 cm (n = 513).[3][Level of evidence A1]

With a median follow-up of 11 years, there was no statistically significant difference in OS between the two treatment groups.

A Swedish multicenter study included 989 patients with primary melanomas located on the trunk or extremities with a tumor thickness between 0.8 mm and 2 mm. Patients were randomly assigned to undergo wide excision with margins of either 2 cm (n = 476) or 5 cm (n = 513).[3][Level of evidence A1]

With a median follow-up of 8 years, there was no statistically significant difference in recurrence-free survival between the two groups.

A Swedish multicenter study included 989 patients with primary melanomas located on the trunk or extremities with a tumor thickness between 0.8 mm and 2 mm. Patients were randomly assigned to undergo wide excision with margins of either 2 cm (n = 476) or 5 cm (n = 513).[3][Level of evidence A1]

The local recurrence rate was 1%, and there was no significant difference between the treatment arms.

A European, multicenter, randomized trial compared margins of 2 cm (n = 161) versus 5 cm (n = 165) in 326 patients with primary melanomas with a thickness of 2.1 mm or less. The study included 141 patients with melanomas measuring 1 mm or less.[4][Level of evidence A1]

A European, multicenter, randomized trial compared margins of 2 cm (n = 161) versus 5 cm (n = 165) in 326 patients with primary melanomas with a thickness of 2.1 mm or less. The study included 141 patients with melanomas measuring 1 mm or less.[4][Level of evidence A1]

There was no statistically significant difference in 10-year DFS or OS between the two treatment groups.

A European, multicenter, randomized trial compared margins of 2 cm (n = 161) versus 5 cm (n = 165) in 326 patients with primary melanomas with a thickness of 2.1 mm or less. The study included 141 patients with melanomas measuring 1 mm or less.[4][Level of evidence A1]

Local recurrence occurred in one patient treated with a 2-cm margin and four patients treated with 5-cm margins.

The Intergroup Melanoma Surgical Trial compared radial excision margins of 2 cm versus 4 cm in patients with melanomas of 1 mm to 4 mm in thickness.[5][Level of evidence A1]

The Intergroup Melanoma Surgical Trial compared radial excision margins of 2 cm versus 4 cm in patients with melanomas of 1 mm to 4 mm in thickness.[5][Level of evidence A1]

With a median follow-up of 10 years, there was no significant difference in OS, disease-specific survival, or local recurrence between the two treatment groups.

A single-center retrospective study included 2,131 patients with melanomas between 1 mm and 2 mm (pT2) in thickness. The study compared excision with histological margins of 8 mm versus 16 mm (corresponding to 1-cm versus 2-cm clinical margins).[6][Level of evidence C1]

A single-center retrospective study included 2,131 patients with melanomas between 1 mm and 2 mm (pT2) in thickness. The study compared excision with histological margins of 8 mm versus 16 mm (corresponding to 1-cm versus 2-cm clinical margins).[6][Level of evidence C1]

There was no significant difference in 5-year melanoma-specific survival (P = .210) or 5-year DFS (P = .202) between the two groups.

A single-center retrospective study included 2,131 patients with melanomas between 1 mm and 2 mm (pT2) in thickness. The study compared excision with histological margins of 8 mm versus 16 mm (corresponding to 1-cm versus 2-cm clinical margins).[6][Level of evidence C1]

On multivariate analysis, peripheral excision margins did not influence local or in-transit recurrence.

Another single-center retrospective study included 576 patients with melanomas of 1 mm to 2 mm (pT2) in thickness. The study compared excision with clinical margins of 1 cm versus 2 cm .[7][Level of evidence C2]

Another single-center retrospective study included 576 patients with melanomas of 1 mm to 2 mm (pT2) in thickness. The study compared excision with clinical margins of 1 cm versus 2 cm .[7][Level of evidence C2]

The local recurrence rate was significantly higher in the 1-cm margin group than in the 2-cm margin group (3.6% vs. 0.9%; P = .044) on univariate analysis, but the rate was no longer significantly different on multivariate analysis.

Another single-center retrospective study included 576 patients with melanomas of 1 mm to 2 mm (pT2) in thickness. The study compared excision with clinical margins of 1 cm versus 2 cm .[7][Level of evidence C2]

There was no difference in OS between the two groups.