1 Versus 2-cm Excision Margins for pT2-pT4 Primary Cutaneous Melanoma (MelMarT): A Feasibility Study

Background There is a lack of consensus regarding optimal surgical excision margins for primary cutaneous melanoma > 1 mm in Breslow thickness (BT). A narrower surgical margin is expected to be associated with lower morbidity, improved quality of life (QoL), and reduced cost. We report the result...

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Published in:Annals of surgical oncology 2018-09, Vol.25 (9), p.2541-2549
Main Authors: Moncrieff, Marc D., Gyorki, David, Saw, Robyn, Spillane, Andrew J., Peach, Howard, Oudit, Deemesh, Geh, Jenny, Dziewulski, Peter, Wilson, Ewan, Matteucci, Paolo, Pritchard-Jones, Rowan, Olofsson Bagge, Roger, Wright, Frances C., Crampton, Nic, Cassell, Oliver, Jallali, Navid, Berger, Adam, Kelly, John, Hamilton, Stephen, Durrani, Amer, Lo, Serigne, Paton, Elizabeth, Henderson, Michael A.
Format: Article
Language:English
Subjects:
Biopsy
Clinical trials
Feasibility studies
Head and neck
Lymph nodes
Medicine
Medicine & Public Health
Melanoma
Melanomas
Morbidity
Oncology
Patients
Quality of life
Surgery
Surgical Oncology
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Summary:Background There is a lack of consensus regarding optimal surgical excision margins for primary cutaneous melanoma > 1 mm in Breslow thickness (BT). A narrower surgical margin is expected to be associated with lower morbidity, improved quality of life (QoL), and reduced cost. We report the results of a pilot international study (MelMarT) comparing a 1 versus 2-cm surgical margin for patients with primary melanoma > 1 mm in BT. Methods This phase III, multicentre trial [NCT02385214] administered by the Australia & New Zealand Medical Trials Group (ANZMTG 03.12) randomised patients with a primary cutaneous melanoma > 1 mm in BT to a 1 versus 2-cm wide excision margin to be performed with sentinel lymph node biopsy. Surgical closure technique was at the discretion of the treating surgeon. Patients’ QoL was measured (FACT-M questionnaire) at baseline, 3, 6, and 12 months after randomisation. Results Between January 2015 and June 2016, 400 patients were randomised from 17 centres in 5 countries. A total of 377 patients were available for analysis. Primary melanomas were located on the trunk (56.9%), extremities (35.6%), and head and neck (7.4%). More patients in the 2-cm margin group required reconstruction (34.9 vs. 13.6%; p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-018-6470-1