The vertical dimension in the surgical treatment of cutaneous malignant melanoma – how deep is deep?

The vertical dimension in the surgical treatment of cutaneous malignant melanoma – how deep is... The surgical treatment of primary cutaneous malignant melanoma has been an issue of debate throughout the past decades. It is generally accepted that the excised tumor-free surgical margins around the lesion should be proportional to the lesion thickness. However, the issue of adequate thickness of tumor-free margins to be resected in the depth of the lesion has not been addressed as yet. In order to assess the influence of thickness of the tumor-free margins resected under malignant melanoma on patients outcome, we have reviewed 48 patients treated for primary cutaneous malignant melanoma in the Rabin Medical Center in the years 1987–1988. Biopsy specimens and clinical charts were evaluated, the tumor-free margin in depth of the excision was measured and compared with clinical outcome. The study population comprised 21 men and 27 women with an average age of 60.2±15.2 years. Most of the primary melanomas were of intermediate thickness with a mean Breslow thickness of 1.6 mm. During a median follow-up time of 112.8 months, ten (21%) patients developed relapse of their malignancy and 13 patients (27.08%) died. In univariate analysis, the thickness of the tumor-free margin excised under the melanoma was one of seven clinical and pathological variables that showed significant predictive value for patient survival. The 10-year survival rate in patients with tumor-free margins thinner than 3 mm was 50%, compared with 82% in patients with thicker tumor-free margins (P=0.01). In multivariate analysis, these margins remained an independent significant prognostic factor, as were four other variables. Evidence indicating a tendency for local and distant melanoma recurrence in thin excisions with small margin/tumor thickness ratio was detected. The recurrence rate in the group with margin/tumor thickness ratio smaller than 1 was nearly five times higher than the rate in patients with higher ratios (66% vs 14%, P=0.003). In univariate and multivariate analysis of 10 years survival, this ratio also proved to be an independent prognostic factor. In this study we have shown that the tumor-free margins resected under the lesion play an important role in the comprehensive surgical treatment of primary cutaneous melanoma and in determining the clinical outcome of the patients. European Journal of Plastic Surgery Springer Journals

The vertical dimension in the surgical treatment of cutaneous malignant melanoma – how deep is deep?

Loading next page...
Copyright © 2001 by Springer-Verlag
Medicine & Public Health; Plastic Surgery
Publisher site
See Article on Publisher Site

There are no references for this article.

You’re reading a free preview. Subscribe to read the entire article.

DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 12 million articles from more than
10,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Unlimited reading

Read as many articles as you need. Full articles with original layout, charts and figures. Read online, from anywhere.

Stay up to date

Keep up with your field with Personalized Recommendations and Follow Journals to get automatic updates.

Organize your research

It’s easy to organize your research with our built-in tools.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

Monthly Plan

  • Read unlimited articles
  • Personalized recommendations
  • No expiration
  • Print 20 pages per month
  • 20% off on PDF purchases
  • Organize your research
  • Get updates on your journals and topic searches


Start Free Trial

14-day Free Trial

Best Deal — 39% off

Annual Plan

  • All the features of the Professional Plan, but for 39% off!
  • Billed annually
  • No expiration
  • For the normal price of 10 articles elsewhere, you get one full year of unlimited access to articles.



billed annually
Start Free Trial

14-day Free Trial