The following is a summary of “Excision margins for melanoma in situ on the head and neck—A single-center 10-year retrospective review of treatment with Mohs micrographic surgery,” published in the June 2024 issue of Dermatology by Tate, et al.

Current guidelines recommend a 5 mm surgical margin for excising melanoma in situ (MIS), yet evidence suggests this may be insufficient for tumor clearance. For a study, researchers sought to assess optimal margin requirements for curing MIS on the head and neck and identify factors associated with needing >5 mm margins for tumor clearance.

A retrospective chart review included 846 cases (807 primary and 39 recurrent) of MIS on the head and neck treated in the authors’ dermatologic surgery department over a 126-month period.

About 62% were cleared with 5 mm margins, while a clearance rate of 97% was achieved with 15 mm margins. The difference in clearance rates between margin thresholds was significant (P < .001). Tumor location on the cheek and larger preoperative size correlated with the need for >5 mm margins for tumor clearance (P = .006 and P = .001, respectively). The study was a single-center retrospective analysis dependent on accurate clinical documentation.

The study highlighted that MIS on the head and neck often requires margins >5 mm for tumor clearance. In cases where Mohs micrographic surgery (MMS) is not feasible, excision margins of ≥10 mm are likely necessary for head and neck tumors.

Reference: jaad.org/article/S0190-9622(24)00102-6/abstract