Surgical margins for excision of primary cutaneous melanoma

Surgical Margins for Lentigo Maligna and Lentigo Maligna Melanoma

“…9 However, the clinical margins of LM and LMM are often poorly defined and may also be masked by ephelides, pigmented actinic keratoses, lentigines, nevi, and seborrheic keratoses. 10 Confirming the difficulties with both clinical and histologic margin control is a study of 92 patients with LM showing that standard surgical excision with "bread-loaf" histologic assessment of margins of LM had incomplete excision rates of 9%, with extrapolated 5-year recurrence rates of lesions thought to be completely excised of 31%.…”

“…9-11,20-25 Zitelli et al 10,22 used a modified form of Mohs surgery to excise 231 head and neck tumors in a series of 553 primary cutaneous melanomas. It is not clear how many of these head and neck tumors were of LM-LMM subtype, although it is likely, given the location, that the majority were LM or LMM.…”

Variation in the Diagnosis, Treatment, and Management of Melanoma In Situ

“…34 Although margins of as little as 3 mm have also been recommended, 35 many subsequent studies using Mohs micrographic surgery have shown that narrow margins may not be adequate. [36][37][38][39][40][41] The optimal-margin controversy stems from the fact that no large-scale prospective controlled studies have examined margins for MIS. It is not surprising that the respondents in our study were divided between supporting a surgical margin of 5 mm or less (57.0%) and greater than 5 mm (33.3%) for MIS.…”

Excision Margins for Primary Cutaneous Melanoma

“…3 However, some authors suggest that tumor thickness should not influence excision margins. 23 More data will need to be collected on these thick tumors to assess the role of wide excision margins.…”