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Surgical excision margins for primary cutaneous melanoma
Cochrane Reviews, 10/09/09

Sladden MJ et al. – None of the five published trials, nor the authors' meta–analysis, showed a statistically significant difference in overall survival between narrow or wide excision. The summary estimate for overall survival favoured wide excision by a small degree, but the result was not significantly different. This result is compatible with both a 5% relative reduction in overall mortality favouring narrower excision and a 15% relative reduction in overall mortality favouring wider excision. Therefore, a small (but potentially important) difference in overall survival between wide and narrow excision margins cannot be confidently ruled out. The summary estimate for recurrence free survival favoured wide excision but again the result did not reach statistical significance. Current randomised trial evidence is insufficient to address optimal excision margins for primary cutaneous melanoma.

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