Wise or Wide? Rethinking Surgical Margins for Melanoma

Wise or Wide? Rethinking Surgical Margins for Melanoma

Authors

  • John Paoli Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden AND Department of Dermatology and Venereology, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden https://orcid.org/0000-0003-1326-8535

Keywords:

Melanoma, Surgery, Dermatological surgical procedures, Margins of excision, Wide local excision

References

Garbe C, Amaral T, Peris K, et al. European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment - Update 2022. Eur J Cancer. 2022;170:256-284. DOI: 10.1016/j.ejca.2022.04.018. PMID: 35623961.

Zijlker LP, Eggermont AMM, van Akkooi ACJ. The end of wide local excision (WLE) margins for melanoma? Eur J Cancer. 2023;178:82-87. DOI: 10.1016/j.ejca.2022.10.028. PMID: 36423526.

Schurink AW, Verhoef C, Waalboer-Spuij R, Mooyaart A, Grünhagen DJ. Evaluation of residual tumour in wide local excision for melanoma: A nationwide population-based study. Eur J Cancer. 2025:115364. DOI: 10.1016/j.ejca.2025.115364. PMID: 40175257.

Stekelenburg I, Laeijendecker AE, van Doorn RC, et al. Reconsidering the surgical approach in cutaneous melanoma: does wide local excision after a complete diagnostic excision reduce the risk of recurrence? Eur J Cancer. 2025:115366. DOI: 10.1016/j.ejca.2025.115366. PMID: 40175258.

Bell KJL, Soyer HP, Ferguson PM. Is Wide Local Excision After Primary Excision of Melanoma In Situ Unnecessary? JAMA Dermatol. 2025. DOI: 10.1001/jamadermatol.2025.3077. PMID: 40900611.

Wennberg E, Bittar R, Svensson H, Paoli J. The Frequency of Microsatellite Metastases, Satellite Metastases, and Residual Tumor in Thin Melanomas: A Retrospective Cohort Study. Dermatol Pract Concept. 2025;15(2). DOI: 10.5826/dpc.1502a5157. PMID: 40401854. PMCID: PMC12090915.

Berglund S, Johansson Backman E, Baldawi Z, et al. Incomplete Excisions of Melanocytic Lesions: Rates and Risk Factors. Acta Derm Venereol. 2021;101(3):adv00421. DOI: 10.2340/00015555-3784. PMID: 33723615. PMCID: PMC9366675.

Weyers W. "Personalized Excision" of Malignant Melanoma-Need for a Paradigm Shift in the Beginning Era of Personalized Medicine. Am J Dermatopathol. 2019;41(12):884-896. DOI: 10.1097/DAD.0000000000001450. PMID: 31490196.

Regional Cancer Centres in Sweden [National Guidelines Malignant Melanoma]. Updated May 2025. Accessed September 24, 2025. https://kunskapsbanken.cancercentrum.se/diagnoser/melanom/vardprogram/

Wennberg E, Claeson M, Olofsson Bagge R, Polesie S, Paoli J. Wise or wide (WoW) study protocol: a national, multicentre, prospective, randomised and controlled, parallel group, non-inferiority study to compare single-staged versus two-staged excisions of thin invasive (≤1.0 mm) melanoma. BMJ Open. 2025;15(4):e094544. DOI: 10.1136/bmjopen-2024-094544. PMID: 40180392. PMCID: PMC11966995.

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Published

2026-01-30

How to Cite

1.
Paoli J. Wise or Wide? Rethinking Surgical Margins for Melanoma. Dermatol Pract Concept. 2026;16(1):6998. doi:10.5826/dpc.1601a6998

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