The Impact of Surgical Margin in Wide Local Excision of Pediatric Melanoma - An Argument for a More Conservative Approach
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- Surgical margins <2cm in pediatric melanoma wide local excision showed no difference in complication rates vs wider margins (n=59, 2007-2023).
- Zero local recurrence observed in either margin group at 52-month median follow-up, suggesting narrower margins may be safe in pediatric cases.
- Study supports more conservative surgical approach in pediatric melanoma, potentially reducing morbidity without compromising oncologic outcomes.
- Single-institution data challenges traditional 2cm margin standard for pediatric melanoma excision; 61% had <2cm margins with excellent results.
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What is the impact of surgical margin during wide local excision of pediatric melanoma? I'm Alex Halpern, a research fellow at Children's National, and this is an article that you should know. Bostedal performed a single institution retrospective review of all pediatric patients who underwent wide local excision of melanoma between 2007 and 2023 to try and answer this question. They compared outcomes of patients whose surgical margins were either greater than or less than 2. Centimeters. They identified 59 patients. 61% had less than 2 centimeter margins. There was no difference in the rates of post-operative complications between the two groups, and at a median follow-up of 52 months, no patients in either group experienced local recurrence. So it seems like narrow margins during wide local excision of pediatric melanoma are not associated with worse outcomes. Does this information change your practice? Let us know what you think in the comments below.