title: A retrospective study of 1- versus 2-cm excision margins for cutaneous malignant melanomas thicker than 2 mm.
abstract: BACKGROUND
  Most guidelines recommend at least 2-cm excision margin for melanomas thicker than 2 mm.
  
  
  OBJECTIVE
  We evaluated whether 1- or 2-cm excision margins for melanoma (>2 mm) result in different outcomes.
  
  
  METHODS
  This is a retrospective cohort study on patients with melanomas (>2 mm) who underwent tumor excision with 1-cm (228 patients) or 2-cm (97 patients) margins to investigate presence of local recurrences, locoregional and distant metastases, and disease-free and overall survival.
  
  
  RESULTS
  In all, 325 patients with mean age of 61.84 years and Breslow thickness of 4.36 mm were considered for the study with a median follow-up of 1852 days (1995-2012). There was no significant difference in the frequency of locoregional and distant metastasis between the 2 groups (P = .311 and .571). The survival analysis showed no differences for disease-free (P = .800; hazard ratio 0.948; 95% confidence interval 0.627-1.433) and overall (P = .951; hazard ratio 1.018; 95% confidence interval 0.575-1.803) survival.
  
  
  CONCLUSIONS
  The study was not prospectively randomized.
  
  
  CONCLUSIONS
  Our study did not show any significant differences in important outcome parameters such as local or distant metastases and overall survival. A prospective study testing 1- versus 2-cm excision margin is warranted.
authors: University Clinic for Dermatology, Bern University Hospital, Inselspital, Bern, Switzerland.
authors: Robert E
authors: RE
authors: Hunger
authors: University Clinic for Plastic, Reconstructive, and Hand Surgery, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.
authors: Sarina
authors: S
authors: Angermeier
authors: University Clinic for Plastic, Reconstructive, and Hand Surgery, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.
authors: S Morteza
authors: SM
authors: Seyed Jafari
authors: University Clinic for Medical Oncology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.
authors: Adrian
authors: A
authors: Ochsenbein
authors: University Clinic for Plastic, Reconstructive, and Hand Surgery, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. Electronic address: maziar_shafighi@yahoo.com.
authors: Maziar
authors: M
authors: Shafighi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016001:Confidence Intervals; D016208:Databases, Factual; D062109:Dermatologic Surgical Procedures / Q000379:methods* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D015580:Mohs Surgery / Q000379:methods / Q000401:mortality; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D000096142:Cutaneous Malignant Melanoma
keywords: disease-free survival; margin of excision; melanomas thicker than 2 mm; metastases; overall survival; recurrences