ABSTRACT
Controversy exists concerning the necessary margin of excision for cutaneous melanoma 2 mm or greater in thickness. This chapter investigates the effect of excision margin on the outcome of patients with high-risk malignant melanoma. Participating surgeons chose one of two primary approaches. The primary tumour could be excised before randomisation, with either a 1 mm or a 1 cm margin to confirm the diagnosis and determine the thickness of the lesion. The median tumour thickness was 3.0 mm in the group with 1 cm margin of excision and 3.1 mm in the group with 3 cm margin of excision. Wide local excision is the most effective treatment for primary cutaneous melanoma, but the optimal width of excision margins has been contentious. Current treatment guidelines are based on a small number of prospective randomised trials, including this one. The head and neck is an anatomically sensitive area and few papers are specific to this site.
