2-cm vs 4-cm surgical excision margins for primary cutaneous melanoma thicker than 2 mm: Long-term follow-up of a multicentre, randomized trial

Source: MDLinx, September 2019

Through an open-label, multicenter randomized controlled trial of 936 individuals from 53 hospitals in Sweden, Denmark, Estonia, and Norway who were clinically staged, 75 years old or younger, and who were diagnosed with localized cutaneous melanoma thicker than 2 mm with primary site on the trunk or upper or lower extremities, researchers followed up on previous findings that a narrow excision margin (2 cm vs 4 cm) did not influence melanoma-specific nor overall survival. A total of 621 deaths were reported, with 304 and 317 in the 2 cm group and in the 4 cm group, respectively, at a median overall follow-up of 19.6 years. A total of 397 deaths were associated with cutaneous melanoma, with 192 and 205 in the 2 cm excision margin group and in the 4-cm excision margin group, respectively. For individuals with thick (> 2 mm) localized cutaneous melanoma, a 2 cm excision margin was safe at a follow-up of the median 19.6 years. In current clinical practice, these conclusions suport the use of 2 cm excision margins.