Title |
1 Versus 2-cm Excision Margins for pT2-pT4 Primary Cutaneous Melanoma (MelMarT): A Feasibility Study
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Published in |
Annals of Surgical Oncology, May 2018
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DOI | 10.1245/s10434-018-6470-1 |
Pubmed ID | |
Authors |
Marc D. Moncrieff, David Gyorki, Robyn Saw, Andrew J. Spillane, Howard Peach, Deemesh Oudit, Jenny Geh, Peter Dziewulski, Ewan Wilson, Paolo Matteucci, Rowan Pritchard-Jones, Roger Olofsson Bagge, Frances C. Wright, Nic Crampton, Oliver Cassell, Navid Jallali, Adam Berger, John Kelly, Stephen Hamilton, Amer Durrani, Serigne Lo, Elizabeth Paton, Michael A. Henderson |
Abstract |
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. 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. 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 < 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. This 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. |
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Country | Count | As % |
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United States | 4 | 29% |
Australia | 3 | 21% |
Peru | 1 | 7% |
Romania | 1 | 7% |
Sweden | 1 | 7% |
Unknown | 4 | 29% |
Demographic breakdown
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Scientists | 5 | 36% |
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Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 73 | 100% |
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Readers by professional status | Count | As % |
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Other | 8 | 11% |
Researcher | 8 | 11% |
Student > Master | 6 | 8% |
Student > Bachelor | 5 | 7% |
Student > Doctoral Student | 4 | 5% |
Other | 9 | 12% |
Unknown | 33 | 45% |
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Nursing and Health Professions | 5 | 7% |
Agricultural and Biological Sciences | 4 | 5% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 1% |
Biochemistry, Genetics and Molecular Biology | 1 | 1% |
Other | 2 | 3% |
Unknown | 40 | 55% |