Surgical margins for resection of primary cutaneous melanoma.

The increasing prevalence of melanoma in the United States is alarming. The limited efficacy of adjuvant therapies in successfully treating regional or distant disease underscores the importance of surgical treatment of primary cutaneous melanoma. The historic paradigm of wide margin excision (5 cm) with or with lymphadenectomy has been proven in multiple clinical trials to show no benefit of improved patient survival. Conservative margin resection of melanoma is a procedure of low morbidity that offers statistically identical outcomes and spares the patient excessive surgical efforts. Mohs micrographic surgery may have a role in the management of melanomas in anatomic sites where standard margins may prove difficult to achieve.