1. Mayo Clinic consensus recommendations for the depth of excision in primary cutaneous melanoma.
- Author
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Grotz TE, Markovic SN, Erickson LA, Harmsen WS, Huebner M, Farley DR, Pockaj BA, Donohue JH, Sim FH, Grant CS, Bagaria SP, Shives TC, Balch CM, and Jakub JW
- Subjects
- Arizona, Clinical Trials as Topic, Consensus, Florida, Health Care Surveys, Humans, Minnesota, Surgical Procedures, Operative methods, Melanoma pathology, Melanoma surgery, Neoplasm Recurrence, Local prevention & control, Practice Patterns, Physicians' statistics & numerical data, Skin Neoplasms pathology, Skin Neoplasms surgery
- Abstract
Currently, no data from randomized controlled clinical trials are available to guide the depth of resection for intermediate-thickness primary cutaneous melanoma. Thus, we hypothesized that substantial variability exists in this aspect of surgical care. We have summarized the literature regarding depth of resection and report the results of our survey of surgeons who treat melanoma. Most of the 320 respondents resected down to, but did not include, the muscular fascia (extremity, 71%; trunk, 66%; and head and neck, 62%). However, significant variation exists. We identified variability in our own practice and have elected to standardize this common aspect of routine surgical care across our institution. In light of the lack of evidence to support resection of the deep muscular fascia, we have elected to preserve the muscular fascia as a matter of routine, except when a deep primary melanoma or thin subcutaneous tissue dictates otherwise.
- Published
- 2011
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