RESECTION MARGINS OF 2 VERSUS 5 CM FOR CUTANEOUS MALIGNANT-MELANOMA WITH A TUMOR THICKNESS OF 0.8 TO 2.0 MM - A RANDOMIZED STUDY BY THE SWEDISH MELANOMA STUDY-GROUP

BACKGROUND. The traditional surgical treatment for primary malignant m elanoma has often been a wide excision with a margin of about 5 cm. Si nce the risk of local recurrences is dependent on tumor thickness, thi n tumors (<1 mm) have routinely been excised with a narrow margin. For thick tumors, the optimal resection margin is controversial, and can be determined only by prospective, randomized trials. METHODS. The Swe dish Melanoma Study Group performed a prospective, randomized multicen ter study to evaluate an excision margin of 2 versus 5 cm for patients with cutaneous malignant melanoma with tumor thickness > 0.8 and less than or equal to 2.0 mm. The trial includes 769 patients. Patients wi th melanomas of the skin of the head, neck, hands, feet, or vulva were not included in the trial. In the event of an excision biopsy for dia gnosis, radical surgery was completed within 6 weeks. The median follo w-up time was 5.8 years for estimation of survival and 4.0 years for d iagnosis of recurrent disease. RESULTS, No significant differences hav e been observed between the treatment groups regarding local or region al recurrences or survival. CONCLUSIONS, We recommend an excision with a margin of 2 cm for cutaneous malignant melanoma with a tumor thickn ess > 0.8 and less than or equal to 2.0 mm. (C) 1996 American Cancer S ociety.