Excision of melanoma in situ on nonchronically sun-exposed skin using 5-mm surgical margins

Welch, Arianna; Reid, T. L.; Knox, J. Marshall; Wilson, Morgan

doi:10.1016/j.jaad.2014.05.021

Cited by 12 publications

(9 citation statements)

References 5 publications

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“…There have, however, been a number of retrospective studies. Contrary to the previously presented data that almost universally support a clinical margin greater than 5 mm to achieve histologically clear margins, three retrospective studies of non-LM MIS support the current guidelines that recommend 5 mm margins only [ 42 – 44 ]. In a review of 155 cases of MIS on non-chronically sun-exposed skin, conventional WLE with 5 mm margins achieved histologic clearance in 100% of cases.…”

Section: Resultsmentioning

confidence: 80%

“…With a mean follow-up of 4 years, the authors reported no recurrences. It should be noted, however, that in this series, the mean clinical diameter of lesions was only 8.7 mm and 45% of cases had a negative margin in the initial biopsy specimen [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…Despite varying study designs and differing surgical techniques, the available data consistently demonstrate that LM, lesions on the head/neck, and/or larger diameter lesions ([ 3 cm) all require wider clinical surgical margins than are recommended in most current melanoma management guidelines to achieve complete histological disease clearance because of the higher likelihood of subclinical spread [46]. However, the question of whether this is necessary for all patients with MIS remains unanswered [42][43][44]. Many of the published studies described above did not separate non-LM MIS from LM, or only studied LM, making it difficult to dissect out true differences.…”

Section: Discussionmentioning

confidence: 99%

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Melanoma In Situ: A Critical Review and Re-Evaluation of Current Excision Margin Recommendations

et al. 2021

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Most international clinical guidelines recommend 5-10 mm clinical margins for excision of melanoma in situ (MIS). While the evidence supporting this is weak, these guidelines are generally consistent. However, as a result of the high incidence of subclinical extension of MIS, especially of the lentigo maligna (LM) subtype, wider margins will often be needed to achieve complete histologic clearance. In this review, we assessed all available contemporary evidence on clearance margins for MIS. No randomized trials were identified and the 31 non-randomized studies were largely retrospective reviews of single-surgeon or single-institution experiences using Mohs micrographic surgery (MMS) for LM

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Section: Resultsmentioning

confidence: 80%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Melanoma In Situ: A Critical Review and Re-Evaluation of Current Excision Margin Recommendations

et al. 2021

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“…The authors concluded that primary excision of MIS should be performed with a surgical margin of 9 mm. However, given that the study did not differentiate between different tumor sites, its findings are subject to controversial debate, even in the US where Mohs surgery is commonly used [5]. Other studies used paraffin-embedded tissue and/or involved wide local excision or staged procedures [2,3,6].…”

Section: Statement Of the German Society Ofmentioning

confidence: 99%

Statement of the German Society of Dermatosurgery: surgical margins in the treatment of melanoma in situ

Bechara

Gauglitz

Kunte

et al. 2019

J Deutsche Derma Gesell

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“…2,3 The 5-mm margin has been well-studied for MIS. [4][5][6][7][8][9] The American Academy of Dermatology (AAD), National Comprehensive Cancer Network (NCCN), and European Society for Medical Oncology (ESMO) recommend 5-mm to 1-cm margins for MIS with the wider surgical margin suggested particularly for the LM subtype. 4,10,11 There are multiple surgical techniques currently recommended for both IM and MIS.…”

mentioning

confidence: 99%

No Recurrence in Primary Invasive Stage 1a and 1b Melanoma and Melanoma in Situ Treated With Serial Disk Staged Excision

et al. 2021

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BACKGROUND Optimal surgical treatment modality for invasive melanoma (IM) and melanoma in situ (MIS) has been debated with proponents for standard wide local excision (WLE), serial disk staged excision, and Mohs micrographic surgery. OBJECTIVE The purpose of this study is to identify the recurrence rates and surgical margins of invasive stage 1 melanoma and MIS lesions using serial disk staged excision technique with rush permanent processing and "bread loafing" microscopic analysis. MATERIALS AND METHODS Recurrence rates and surgical margins of 63 IM and 207 MIS at the University of California Dermatology Surgery Unit were retrospectively reviewed. RESULTS No recurrences were observed with average follow-up of 34 and 36 months for IM and MIS, respectively (range, 10-92 months). Average surgical margins were 19.8 mm (SD 9.7) for IM and 12.1 mm (SD 12.2) for MIS. CONCLUSION This SSE technique for the treatment of IM and MIS is comparable in efficacy to other SSE techniques, and it offers physicians a simple and accessible alternative to WLE and MMS.

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Excision of melanoma in situ on nonchronically sun-exposed skin using 5-mm surgical margins

Cited by 12 publications

References 5 publications

Melanoma In Situ: A Critical Review and Re-Evaluation of Current Excision Margin Recommendations

Melanoma In Situ: A Critical Review and Re-Evaluation of Current Excision Margin Recommendations

Statement of the German Society of Dermatosurgery: surgical margins in the treatment of melanoma in situ

No Recurrence in Primary Invasive Stage 1a and 1b Melanoma and Melanoma in Situ Treated With Serial Disk Staged Excision

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