In this issue, Moyer and colleagues1 report long-term follow-up of a large cohort of patients with head and neck melanoma treated with a “square” staged excision technique using permanent sections for comprehensive margin assessment. The median follow-up of 9.3 years demonstrated excellent long-term disease control of 834 lesions with projected local recurrence rate of 2.2% at 10 years. The mean margin required for histologic clearance of tumor was 9.3 mm for melanoma in situ and 13.7 mm for invasive melanoma. The authors demonstrated that lesion size, presence of invasion, and prior incomplete excision were associated with larger surgical margins required for histologic clearance.
Connolly KL, Busam KJ, Nehal KS. Optimizing Outcomes for Cutaneous Head and Neck Melanoma. JAMA Dermatol. 2017;153(3):267-268. doi:10.1001/jamadermatol.2016.4604