A retrospective study of 1-versus 2-cm excision margins for cutaneous malignant melanomas thicker than 2 mm

作者：Hunger Robert E; Angermeier Sarina; Jafari S Morteza Seyed; Ochsenbein Adrian; Shafighi Maziar^*

来源：Journal of the American Academy of Dermatology, 2015, 72(6): 1054-1059.

DOI：10.1016/j.jaad.2015.03.029

• disease-free survival
• margin of excision
• melanomas thicker than 2 mm
• metastases
• overall survival
• recurrences

Background: Most guidelines recommend at least 2-cm excision margin for melanomas thicker than 2 mm.
Objective: We evaluated whether 1- or 2-cm excision margins for melanoma ([2 mm) result in different outcomes.
Methods: This is a retrospective cohort study on patients with melanomas ([2 mm) who underwent tumor excision with 1-cm (228 patients) or 2-cm (97 patients) margins to investigate presence of local recurrences, locoregional and distant metastases, and disease-free and overall survival.
Results: In all, 325 patients with mean age of 61.84 years and Breslow thickness of 4.36 mm were considered for the study with a median follow-up of 1852 days (1995-2012). There was no significant difference in the frequency of locoregional and distant metastasis between the 2 groups (P = .311 and .571). The survival analysis showed no differences for disease-free (P = .800; hazard ratio 0.948; 95% confidence interval 0.627-1.433) and overall (P = .951; hazard ratio 1.018; 95% confidence interval 0.575-1.803) survival.
Limitations: The study was not prospectively randomized.
Conclusions: Our study did not show any significant differences in important outcome parameters such as local or distant metastases and overall survival. A prospective study testing 1-versus 2-cm excision margin is warranted.

• 出版日期2015-6