title: Surgical excision margin for primary acral melanoma.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Kyeong-Tae
authors.initials: KT
authors.lastname: Lee
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Eun-Ji
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Dong-Youn
authors.initials: DY
authors.lastname: Lee
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Jung-Han
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Kee-Taek
authors.initials: KT
authors.lastname: Jang
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Goo-Hyun
authors.initials: GH
authors.lastname: Mun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005528:Foot; D006225:Hand; D006801:Humans; D008297:Male; D000072662:Margins of Excision; D008545:Melanoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis
keywords: acral melanoma; excision margin; local recurrence; sentinel lymph node biopsy; survival