ArticleAnnals of the Royal College of Surgeons of England2020
'Primum non nocere': how harmless is routine wide local excision for AJCC stage IA melanoma?
Article in Annals of the Royal College of Surgeons of England, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Narrow Excision Margins for Diverse Histological Subtypes of Cutaneous Melanoma in Children and Adults: A Systematic Review.Dermatology and therapy · 2026Pooled it
- Article
- The Frequency of Microsatellite Metastases, Satellite Metastases, and Residual Tumor in Thin Melanomas: A Retrospective Cohort Study.Dermatology practical & conceptual · 2025Article
- Phase-specific and laser-modulated polydopamine-chlorella-curdlan hydrogels: pioneering a melanoma integrative therapy.Theranostics · 2025Article
- Association of Excision Margin Size With Local Recurrence and Survival in Patients With T1a Melanoma at Critical Structures.JAMA dermatology · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundManagement of primary cutaneous malignant melanoma is with initial excision biopsy followed by a wide local excision to achieve locoregional control. For low-risk thin melanomas, the added survival benefit from the wide local excision is minimal. In this study, we investigated the morbidities of wide local excision and evaluated the current clinical practice in managing stage IA malignant melanoma.
methodsPatients with confirmed stage IA malignant melanoma who had undergone a wide local excision in the 2013/14 period were identified using a specialist cancer multidisciplinary team-held database. Primary pathology, surgical data and follow-up documentation were analysed.
resultsA total of 231 cases were identified; 95% of patients (
conclusionsWe demonstrated that 1cm wide local excision is associated with significant morbidity, which can affect patients' physical, psychological and social wellbeing. Since wide local excision does not give a survival advantage, and its margin is already frequently reduced in cosmetically sensitive areas, the need for a second full 1cm wide local excision procedure for thin melanoma should be re-evaluated, especially when 95% of our study cohort had their malignant melanoma completely excised by the initial biopsy alone.
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Registered trials
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