Surgical excision margin for primary acral melanoma

J Surg Oncol. 2016 Dec;114(8):933-939. doi: 10.1002/jso.24442. Epub 2016 Sep 19.

Abstract

Background and objectives: This study aimed to evaluate treatment outcomes of acral melanoma (AM) based on the excision margin.

Methods: A retrospective cohort study was conducted for patients with primary AM, analyzing recurrence rates, local and in-transit recurrence-free survival (LITRFS), disease-free survival (DFS), and melanoma-specific survival (MSS).

Results: Data from 129 patients of AM were analyzed. In 53 patients with thin AM (thickness ≤1 mm), neither recurrence nor mortality occurred regardless of whether the excision margin was >1 cm or not. Seventy-six patients had thick AM (thickness >1 mm), including 36 treated with a <2 cm excision margin and 40 with a 2 cm margin. Multivariate analyses revealed that a 2 cm margin was associated with a reduced rate of local recurrence (HR, 0.120; P-value = 0.023) and LITR (HR, 0.187; P-value = 0.013) compared with a <2 cm margin. DFS and MSS did not differ between the two groups.

Conclusions: Thin AM were successfully treated with a 1 cm excision margin. For thick AM, a 2 cm excision margin provided improved local control, compared with a <2 cm margin; however, this benefit did not translate into a survival gain. J. Surg. Oncol. 2016;114:933-939. © 2016 Wiley Periodicals, Inc.

Keywords: acral melanoma; excision margin; local recurrence; sentinel lymph node biopsy; survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Foot
  • Hand
  • Humans
  • Male
  • Margins of Excision*
  • Melanoma / mortality
  • Melanoma / pathology
  • Melanoma / surgery*
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / etiology
  • Retrospective Studies
  • Skin Neoplasms / mortality
  • Skin Neoplasms / pathology
  • Skin Neoplasms / surgery*
  • Survival Analysis