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

We report the results of a pilot international study (MelMarT) comparing a 1 versus 2-cm surgical margin for patients with primary melan oma >  1 mm in BT.MethodsThis 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.ResultsBetween 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 <  0.0001). There was an increased wound necrosis rate in the 2-cm arm (0.5 vs. 3.6%;p = 0.036). After 12 months’ follow-up, no differences were noted in QoL between groups.DiscussionThis pilot study demonstrates the feasibility of a large international RCT to provide a definitive answer to the optimal excision margin for patients with intermediate- to high-risk primary cutaneous melanoma.
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research