ArticleJournal of the American Academy of Dermatology2012
Surgical margins for melanoma in situ.
Article in Journal of the American Academy of Dermatology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
44 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Interventions for melanoma in situ, including lentigo maligna.The Cochrane database of systematic reviews · 2014Pooled it
- Guidelines of the Brazilian Dermatology Society for diagnosis, treatment and follow up of primary cutaneous melanoma--Part I.Anais brasileiros de dermatologiaGuideline
- Indications and Mechanisms of Action of the Main Treatment Modalities for Non-Melanoma Skin Cancer.Life (Basel, Switzerland) · 2025Review
- Deferred Lateral Margin Control in the Surgical Treatment of Genital Paget's Disease and Lentiginous Vulvar Melanoma.Journal of clinical medicine · 2024Article
- Risk factors associated with tumor upstaging in melanomas treated with Mohs micrographic surgery with melanocytic immunohistochemistry.JAAD international · 2024Article
- Pixel-level classification of pigmented skin cancer lesions using multispectral autofluorescence lifetime dermoscopy imaging.Biomedical optics express · 2024Article
- Establishing Consensus for Mohs Micrographic Surgical Techniques in the Treatment of Melanoma in Situ for Future Clinical Trials: A Modified Delphi Study.Journal of the National Comprehensive Cancer Network : JNCCN · 2024Article
- Primary Cutaneous Melanoma-Management in 2024.Journal of clinical medicine · 2024Article
- Recent advancements in the diagnosis and treatment of acral melanoma.Journal of Zhejiang University. Science. B · 2024Review
- Double V-Y Island Pedicle Flap for Dorsal Hand Reconstruction Following Mohs Micrographic Surgery.Cureus · 2023Article
- Review
- Malignant melanoma: evolving practice management in an era of increasingly effective systemic therapies.Current problems in surgery · 2022Review
- Comparison of photoacoustic imaging and histopathological examination in determining the dimensions of 52 human melanomas and neviBiomedical optics express · 2021Article
- Melanoma In Situ: A Critical Review and Re-Evaluation of Current Excision Margin Recommendations.Advances in therapy · 2021Review
- Incompletely excised lentigo maligna melanoma is associated with unpredictable residual disease: clinical features and the emerging role of reflectance confocal microscopy.Journal of the European Academy of Dermatology and Venereology : JEADV · 2020Article
- Histological Peripheral Margins and Recurrence of Melanoma In Situ Treated with Wide Local Excision.Journal of skin cancer · 2020Article
- Reflectance confocal microscopy and dermoscopy aid in evaluating repigmentation within or adjacent to lentigo maligna melanoma surgical scars.Journal of the European Academy of Dermatology and Venereology : JEADV · 2020Article
- Lentigo Maligna: Clinical Presentation and Appropriate Management.Clinical, cosmetic and investigational dermatology · 2020Review
- Primary excision margins, sentinel lymph node biopsy, and completion lymph node dissection in cutaneous melanoma: a clinical practice guideline.Current oncology (Toronto, Ont.) · 2019Article
- NEO412: A temozolomide analog with transdermal activity in melanomaOncotarget · 2018Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA controversy in the treatment of melanoma in situ is the required width of surgical margin. The currently accepted 5-mm margin is based on a 1992 consensus opinion, despite data since then showing this is inadequate.
objectiveWe sought to develop guidelines for predetermined surgical margins for excision of melanoma in situ.
methodsA prospectively collected series of 1072 patients with 1120 melanoma in situs was studied. All lesions were excised by Mohs micrographic surgery with frozen-section examination of the margin. The minimal surgical margin was 6 mm, and the total margin was calculated by adding an additional 3 mm for each subsequent stage required. The minimum surgical margin that would successfully remove 97% of all tumors was calculated. Local recurrence was also tabulated.
resultsIn all, 86% of melanoma in situs were successfully excised with a 6-mm margin; 9 mm removed 98.9% of melanoma in situs. The superiority of 9-mm to 6-mm margins was significant (P < .001). Gender, location, and diameter did not affect results. Recurrence rate for this set of patients treated with Mohs micrographic surgery was 0.3% (n = 3). LIMITATIONS: Margins less than 6 mm were not studied. This is a referral center for melanoma in situ and 10% of tumors were previously treated before presentation to our clinic.
conclusionThe frequently recommended 5-mm margin for melanoma is inadequate. Standard surgical excision of melanoma in situ should include 9 mm of normal-appearing skin, similar to that recommended for early invasive melanoma.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.