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Primary tumour excision with a surrounding margin of 3 cm reduced recurrence in melanomas > 2 mm thick

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 Q In patients with high risk malignant melanoma, is primary tumour excision with a surrounding margin of 3 cm more effective than a margin of 1 cm for reducing recurrence and improving survival?

Clinical impact ratings Dermatology ★★★★★★☆ Oncology ★★★★★★☆ Surgery ★★★★☆☆☆


Embedded ImageDesign:

randomised controlled trial.

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded (monitoring committee).*

Embedded ImageFollow up period:

a median of 60 months.

Embedded ImageSetting:

21 hospitals, 2 infirmaries, 1 cancer therapy network in the UK, and 1 cancer centre in Poland.

Embedded ImagePatients:

900 patients >18 years of age (mean age 57 y, 52% men) who had a single primary localised cutaneous melanoma (⩾2 mm in thickness) on the trunk or limbs (excluding the palms of hands or the soles of the feet) where a 3 cm excision margin was technically possible. Exclusion criteria included pregnancy, a history of cancer (except basal cell carcinoma), and treatment with immunosuppressive agents.

Embedded ImageIntervention:

primary …

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  • * See glossary.

  • For correspondence: Mr J M Thomas, Royal Marsden Hospital National Health Service Trust, London, UK.

  • Sources of funding: 6 funding agencies.