2-cm versus 4-cm surgical excision margins for primary cutaneous melanoma thicker than 2 mm: a randomised, multicentre trial

Chinese Guidelines on the Diagnosis and Treatment of Melanoma (2015 Edition)

“…The safe cutting edge during the extended resection should be decided according to the depth of tumor infiltration: (I) the safe cutting edge is 1 cm if the lesion thickness is ≤1.0 mm; (II) the safe cutting edge is 1−2 cm if the lesion thickness is 1.01−2.0 mm; (III) the safe cutting edge is 2 cm if the lesion thickness is >2 mm; and (IV) the safe cutting edge is 2 cm, as supported by new evidences, the lesion thickness is >4.0 mm. A European multicenter, randomized study included 936 melanoma patients with tumor thickness >2.0 mm, in whom extended resection with a cutting edge of 2 or 4 cm was performed; the results showed the overall 5-year survival rates were similar in both groups (46). These findings were similar to the previous studies (47)(48)(49).…”

Distinct Subcellular Localization of GSK-3<i>β</i> in Melanocytic Nevi: Implications in Melanocyte Senescence

“…Current recommendations are 0.5 cm margins for melanoma in situ, 1.0 cm margins for tumors less than 1.0 mm in Breslow thickness (BT), and 2.0 cm surgical margins for tumors of intermediate thickness (BT = 1 -4 mm) and high risk tumors (BT > 4.0 mm) [8][9][10]. Lymphatic mapping with sentinel lymph node biopsy is recommended in patients with tumors greater than 1.0 mm in thickness.…”

Excision margins for primary melanomas: A controversial issue

“…In order to narrow the resection margins for cutaneous melanoma thicker than 2-mm treatment, a randomized clinical trial in 2004 compared 3-cm and 1-cm resection margins, where a 1-cm excision margin was correlated with a significantly greater risk of regional recurrences that did not impact overall survival [3] . However, another randomized controlled trial on 4-cm versus 2-cm resection margins suggested 2 cm as a sufficient and safe resection margin for cutaneous melanomas thicker than 2 mm [2] . Furthermore, a recent study comparing 3-cm versus 1-cm excision margins for primary cutaneous melanomas thicker than 2 mm declared that a 1-cm excision margin is inadequate for such cutaneous melanomas on the trunk and limbs [10] .…”

“…The selection of optimal excision margins is crucial to maximize outcomes and minimize morbidities [1][2][3][4][5] . Insufficient resection may lead residual tumor cells to disease recurrences [1,6] .…”

“…Insufficient resection may lead residual tumor cells to disease recurrences [1,6] . However, unnecessarily tissue excisions might cause greater morbidities, along with bad functional and cosmetic results [1][2][3] . The determination of melanoma excision margins has been an important issue since the earliest descriptions of melanoma [4] .…”