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Throughout most of the 20th century, the standard treatment of intermediate-depth or deep melanoma was resection with 5-cm margins and elective regional lymph node dissection. It was not until 1977 that Breslow and Macht1 suggested that narrower margins may be sufficient to obtain local control without compromising survival. Nearly 2 decades later, large randomized trials changed the management of melanoma in favor of narrower surgical margins and nodal staging with sentinel lymph node biopsy (SLNB).
Bichakjian CK, Harms KL, Schwartz JL. Selective Use of Adjuvant Therapy in the Management of Merkel Cell Carcinoma. JAMA Oncol. 2015;1(8):1162–1163. doi:10.1001/jamaoncol.2015.1503
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