OBJECTIVE: Prospective trials have shown that 1-cm and 2-cm margins are safe for melanomas <1 mm thick and > or =1 mm thick, respectively. It is unknown whether narrower margins increase the risk of LR or mortality. SUMMARY BACKGROUND DATA: To determine the relationship between histopathologic excision margin, local recurrence (LR) and survival for patients with melanomas < or =2 mm thick. METHODS: Data were extracted from the Sydney Melanoma Unit database for all patients with cutaneous melanoma < or =2 mm thick, diagnosed up to 1996. Patients with positive excision margins or follow-up <12 months were excluded, leaving 2681 for analysis. Outcome measures were LR (recurrence <5 cm from the excision scar), in-transit recurrence, and disease-specific survival. Factors predicting LR and overall survival were tested with Cox proportional hazards analysis. RESULTS: Median follow-up was 83.8 months. LR was identified in 55 patients (median time to recurrence, 37 months). At 120 months, the actuarial LR rate was 2.9%. Five-year survival after LR was 52.8%. In multivariate analysis, only margin of excision and tumor thickness were predictive of LR (both P = 0.003). When all patients with a margin <0.8 cm in fixed tissue (corresponding to a margin of <1 cm in vivo) were excluded from analysis, margin was no longer significant in predicting LR. Thickness, ulceration, and site were predictive of survival, but margin was not (P = 0.49). CONCLUSIONS: Histopathologic margin affects the risk of LR. However, if the in vivo margin is > or =1 cm, it no longer predicts risk of LR. Patient survival is not affected by margin.
OBJECTIVE: Prospective trials have shown that 1-cm and 2-cm margins are safe for melanomas <1 mm thick and > or =1 mm thick, respectively. It is unknown whether narrower margins increase the risk of LR or mortality. SUMMARY BACKGROUND DATA: To determine the relationship between histopathologic excision margin, local recurrence (LR) and survival for patients with melanomas < or =2 mm thick. METHODS: Data were extracted from the Sydney Melanoma Unit database for all patients with cutaneous melanoma < or =2 mm thick, diagnosed up to 1996. Patients with positive excision margins or follow-up <12 months were excluded, leaving 2681 for analysis. Outcome measures were LR (recurrence <5 cm from the excision scar), in-transit recurrence, and disease-specific survival. Factors predicting LR and overall survival were tested with Cox proportional hazards analysis. RESULTS: Median follow-up was 83.8 months. LR was identified in 55 patients (median time to recurrence, 37 months). At 120 months, the actuarial LR rate was 2.9%. Five-year survival after LR was 52.8%. In multivariate analysis, only margin of excision and tumor thickness were predictive of LR (both P = 0.003). When all patients with a margin <0.8 cm in fixed tissue (corresponding to a margin of <1 cm in vivo) were excluded from analysis, margin was no longer significant in predicting LR. Thickness, ulceration, and site were predictive of survival, but margin was not (P = 0.49). CONCLUSIONS: Histopathologic margin affects the risk of LR. However, if the in vivo margin is > or =1 cm, it no longer predicts risk of LR. Patient survival is not affected by margin.
Authors: David Khayat; Olivier Rixe; Ginette Martin; Claude Soubrane; Martine Banzet; Jacques-André Bazex; Philippe Lauret; Olivier Vérola; Gérard Auclerc; Peter Harper; Pierre Banzet Journal: Cancer Date: 2003-04-15 Impact factor: 6.860
Authors: J Meirion Thomas; Julia Newton-Bishop; Roger A'Hern; Gill Coombes; Michael Timmons; Judy Evans; Martin Cook; Jeffery Theaker; Mary Fallowfield; Trevor O'Neill; Wlodek Ruka; Judith M Bliss Journal: N Engl J Med Date: 2004-02-19 Impact factor: 91.245
Authors: M K Silverman; F M Golomb; A W Kopf; C M Grin-Jorgensen; K A Vossaert; J P Doyle; M J Levenstein Journal: J Am Acad Dermatol Date: 1992-08 Impact factor: 11.527
Authors: Travis E Grotz; Svetomir N Markovic; Lori A Erickson; William S Harmsen; Marianne Huebner; David R Farley; Barbara A Pockaj; John H Donohue; Franklin H Sim; Clive S Grant; Sanjay P Bagaria; Thomas C Shives; Charles M Balch; James W Jakub Journal: Mayo Clin Proc Date: 2011-06 Impact factor: 7.616
Authors: Alexander H R Varey; Chris Goumas; Angela M Hong; Graham J Mann; Gerald B Fogarty; Jonathan R Stretch; Robyn P M Saw; Andrew J Spillane; Kerwin F Shannon; Kenneth J Lee; Michael J Quinn; John F Thompson; Richard A Scolyer Journal: Mod Pathol Date: 2017-07-21 Impact factor: 7.842