TY - JOUR T1 - Primary tumour excision with a surrounding margin of 3 cm reduced recurrence in melanomas > 2 mm thick JF - Evidence Based Medicine JO - Evid Based Med SP - 183 LP - 183 DO - 10.1136/ebm.9.6.183 VL - 9 IS - 6 A2 - , Y1 - 2004/11/01 UR - http://ebm.bmj.com/content/9/6/183.abstract N2 - Thomas JM, Newton-Bishop J, A’Hern R, et al. Excision margins in high-risk malignant melanoma. N Engl J Med 2004;350:757–66.OpenUrlCrossRefPubMedWeb of Science 
 
 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 ★★★★☆☆☆ Design: randomised controlled trial. Allocation: concealed.* Blinding: blinded (monitoring committee).* Follow up period: a median of 60 months. Setting: 21 hospitals, 2 infirmaries, 1 cancer therapy network in the UK, and 1 cancer centre in Poland. Patients: 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. Intervention: primary … ER -