Are Positive Biopsy Margins in Melanoma Significant?: A Cohort Study of Micro- Versus Macroscopic Margin Status and Their Impact on Residual Disease and Survival

Background Presence of positive biopsy margins in melanoma can provoke anxiety over potential disease progression from delays to surgical excision, but their impact on outcomes is unknown. We aimed to compare the presence of residual melanoma in the surgical excision specimen and survival between pa...

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Published in:Annals of surgical oncology 2025, Vol.32 (1), p.474-481
Main Authors: Lee, Alex, Wong, Boaz, Li, Heidi, Grose, Elysia, Brandts-Longtin, Olivier, Aw, Katherine, Lau, Rebecca, Abed, Ahmad, Stevenson, James, Sheikh, Rahat, Chen, Richard, Goulet, Clara, Johnson-Obaseki, Stephanie, Nessim, Carolyn
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biopsy
Female
Follow-Up Studies
Humans
Lymph nodes
Male
Margins of Excision
Medical prognosis
Medicine
Medicine & Public Health
Melanoma
Melanoma - mortality
Melanoma - pathology
Melanoma - surgery
Melanoma and Cutaneous Oncology
Middle Aged
Neoplasm Recurrence, Local - pathology
Neoplasm Recurrence, Local - surgery
Neoplasm, Residual - pathology
Oncology
Prognosis
Retrospective Studies
Sentinel Lymph Node Biopsy
Skin Neoplasms - mortality
Skin Neoplasms - pathology
Skin Neoplasms - surgery
Surgery
Surgical Oncology
Survival
Survival Rate
Young Adult
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Summary:Background Presence of positive biopsy margins in melanoma can provoke anxiety over potential disease progression from delays to surgical excision, but their impact on outcomes is unknown. We aimed to compare the presence of residual melanoma in the surgical excision specimen and survival between patients with negative, microscopically positive, and macroscopically positive biopsy margins. Methods Patients with cutaneous melanoma who underwent surgical excision over a 13-year period were included. Biopsy characteristics, residual disease in the surgical specimen, and overall and recurrence-free survival were compared between patients with negative, microscopically positive (only scar visible), and macroscopically positive (visible remaining melanoma) biopsy margins. Results Of 901 patients, 42.4%, 33.3%, and 24.3% had negative, microscopically positive, and macroscopically positive margins, respectively. The incidence of residual invasive melanoma in the surgical specimen varied ( P  
ISSN:1068-9265
1534-4681
1534-4681
DOI:10.1245/s10434-024-16301-w