A 2cm excision margin on skin melanomas thicker than 2mm is as safe as a 4cm margin, finds a European study.
Researchers conducted a randomised controlled trial between 1992 and 2004, with some of the patients followed up until 2011. Some 936 patients from Sweden, Norway, Denmark and Estonia had a skin melanoma thicker than 2mm, at clinical stage IIA-C, with 465 allocated to have the melanoma excised with a 2cm margin, and 471 allocated to a 4cm margin.
Five-year overall survival was 65%, and recurrence at five years 44%, in both groups. After median follow-up of 6.7 years, 39% of patients in the 2cm group and 38% in the 4cm group had died.
The researchers said there was a need to strike a balance in removing a melanoma between relapse risk with a narrow excision and the possible complications of a wide excision, such as poor cosmetic results, longer hospital stay and need for skin grafts.
Study leader Dr Peter Gillgren, surgeon at Stockholm Sodersjukhuset said: ‘Our study is the largest randomised controlled trial of resection margins for thick melanomas. Overall survival was equal in the two groups.'
Lancet 2011, published online 24 October
Click here to watch our clinical skills video series on skin surgery
