Excision of underlying fascia with a primary malignant melanoma: effect on recurrence and survival rates.

Patients with stages O and I malignant melanomas of the trunk and proximal limbs, having had wide excisions only without lymph node dissections, were reviewed to determine whether the presence or absence of muscle fasciae correlated with prognosis. Prior to 1969 most patients seen at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston with primary melanomas underwent wide excision of their lesions including muscle fasciae; however, after 1969 the fasciae were not resected in most patients. Records of 107 patients in whom fasciae were excised and 95 patients in whom fasciae were preserved, all with 5-year follow-up, were analyzed. Although a trend was present in favor of the patients in whom the fascia was removed (20% regional recurrence rate versus 25%), the incidence of subsequent recurrence, site of recurrence, and survival were not statistically different between the two groups. This review has not confirmed the hypothesis that the excision of muscle fasciae correlates with recurrence or survival in patients treated for primary malignant melanoma.