For patients with cutaneous melanoma thicker than 2 mm, a surgical excision margin of 2 cm is sufficient and has similar overall survival as with a 4-cm excision margin, according to a study published online Oct. 24 in The Lancet.
Peter Gillgren, M.D., from the Karolinska Institutet in Stockholm, Sweden, and colleagues compared survival with surgical resection margin of 2 cm versus 4 cm in a controlled trial of 936 patients with clinical stage IIA to C cutaneous melanoma thicker than 2 mm. Randomization was done by sealed envelope or by computer generated lists with permuted blocks, and 465 and 471 participants were allocated to treatment with a 2-cm or a 4-cm resection margin, respectively. One patient died in each group during follow-up but were included in the analysis. Overall survival was the primary end point. No systematic recording was done for adverse events.
The investigators found that, after a median follow-up of 6.7 years, 181 and 177 patients died in the 2-cm and 4-cm margin groups, respectively (hazard ratio, 1.05; 95 percent confidence interval, 0.85 to 1.29). The five-year overall survival was the same in both groups at 65 percent.
"Our findings suggest that a 2-cm resection margin is sufficient and safe for patients with cutaneous melanoma thicker than 2 mm," the authors write.
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