Excision margins for primary melanomas: A controversial issue

  • S. Morteza Seyed Jafari Bern University Hospital
DOI: https://doi.org/10.18282/jsd.v2.i3.163
Keywords: Margin of excision, metastases, primary melanoma, recurrences, survival

Abstract

Surgical excision is the principal treatment for primary cutaneous melanoma.Selection of optimal excision margins is crucial to maximize outcomes and minimize morbidities.Insufficient resection may lead residual tumor cells to disease recurrences.

References

Hunger RE, Angermeier S, Seyed Jafari SM, Ochsenbein A, Shafighi M. A retrospective study of 1- versus 2-cm excision margins for cutaneous malignant melanomas thicker than 2 mm. J Am Acad Dermatol 2015; 72(6): 1054–1059. doi: 10.1016/j.jaad.2015.03.029

Gillgren P, Drzewiecki KT, Niin M, Gullestad HP, Hellborg H, et al. 2-cm versus 4-cm surgical excision margins for primary cutaneous melanoma thicker than 2 mm: A randomised, multicentre trial. Lancet 2011; 378(9803): 1635–1042. doi: 10.1016/S0140-6736(11)61546-8

Thomas JM, Newton-Bishop J, A'Hern R, Coombes G, Timmons M, et al. Excision margins in high-risk malignant melanoma. N Engl J Med 2004; 350(8): 757–766. doi: 10.1056/NEJMoa030681

Ethun CG, Delman KA. The importance of surgical margins in melanoma. J Surg Oncol 2016; 113(3): 339–345. doi: 10.1002/jso.24111

Hudson LE, Maithel SK, Carlson GW, Rizzo M, Murray DR, et al. 1 or 2 cm margins of excision for T2 melanomas: Do they impact recurrence or survival? Ann Surg Oncol 2013; 20(1): 346–351. doi: 10.1245/s10434-012-2543-8

Seyed Jafari SM, Hunger RE, Shafighi M. Lack of strong evidence with regard to the depth of thick melanoma excision. Br J Dermatol 2015; 173(4): 1095. doi: 10.1111/bjd.13871

Handley WS. Pathology of melanotic growths in relation to their operative treatment. Lancet 1907; 169(4363): 996–1003. doi: 10.1016/S0140-6736(01)54641-3.

Breslow A, Macht S. Optimal size of resection margin for thin cutaneous melanoma. Surg Gynecol Obstet 1977; 145(5): 691–692.

Veronesi U, Cascinelli N. Narrow excision (1-cm margin): A safe procedure for thin cutaneous melanoma. Arch Surg 1991; 126(4): 438–441. doi: 10.1001/archsurg.1991.01410280036004

Hayes AJ, Maynard L, Coombes G, Newton-Bishop J, Timmons M et al. Wide versus narrow excision margins for high-risk, primary cutaneous melanomas: Long-term follow-up of survival in a randomised trial. Lancet Oncol 2016; 17(2): 184–192. doi: 10.1016/S1470-2045(15)00482-9

Rosko AJ, Vankoevering KK, McLean SA, Johnson TM, Moyer JS. Contemporary management of early-stage melanoma: A systematic review. JAMA Facial Plast Surg 2017; 19(3): 232–238. doi: 10.1001/jamafacial.2016.1846

Published
2020-07-18
Issue
Vol. 5 No. 2 (2020)
Section
Editorials

Copyright (c) 2020 Seyed Jafari SM.

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