I disagree with the conclusion reached by Piepkorn and Barnhill in a recent Archives article1 that "the choice of a resection margin [for melanoma] materially more than 1 cm has no basis in scientifically observable fact," regardless of Breslow thickness. Indeed, the only published randomized controlled trial2 of 1-cm resection margins provides a scientific basis for recommending 2-cm resection margins for primary cutaneous melanomas greater than 1 mm in Breslow thickness.
That trial randomized patients with primary melanomas less than 2 mm in Breslow thickness to 1- or 3-cm resection margins. There were no overall survival differences, but all 4 local recurrences occurred in patients whose primary melanomas were in the 1- to 2-mm-thickness group and were resected with 1-cm (narrow) margins. Since other published randomized trials3 4 have shown no benefit of resection margins wider than 2 cm on local or overall recurrence rates, these findings
Weinstock MA. Resection Margins in Primary Cutaneous Melanoma. Arch Dermatol. 1997;133(1):103. doi:10.1001/archderm.1997.03890370115020