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Long term results of a randomized study by the Swedish Melanoma Study Group on 2-cm versus 5-cm resection margins for patients with cutaneous melanoma with a tumor thickness of 0.8-2.0 mm
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- Cohn-Cedermark, G (author)
- Karolinska Hosp, Radiumhemmet, Dept Oncol Pathol, S-17176 Stockholm, Sweden Karolinska Hosp, Ctr Oncol, Dept Oncol Pathol, S-10401 Stockholm, Sweden Univ Umea Hosp, Dept Radiat Sci, S-90185 Umea, Sweden Orebro Reg Hosp, Dept Oncol, Orebro, Sweden Univ Lund Hosp, Dept Surg, S-22185 Lund, Sweden Helsingborg Hosp, Dept Surg, Helsingborg, Sweden Linkoping Univ Hosp, Dept Hand Surg Plast Surg & Burns, S-58185 Linkoping, Sweden Ryhov Cty Hosp, Dept Oncol, Jonkoping, Sweden
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- Rutqvist, LE (author)
- Karolinska Hosp, Radiumhemmet, Dept Oncol Pathol, S-17176 Stockholm, Sweden Karolinska Hosp, Ctr Oncol, Dept Oncol Pathol, S-10401 Stockholm, Sweden Univ Umea Hosp, Dept Radiat Sci, S-90185 Umea, Sweden Orebro Reg Hosp, Dept Oncol, Orebro, Sweden Univ Lund Hosp, Dept Surg, S-22185 Lund, Sweden Helsingborg Hosp, Dept Surg, Helsingborg, Sweden Linkoping Univ Hosp, Dept Hand Surg Plast Surg & Burns, S-58185 Linkoping, Sweden Ryhov Cty Hosp, Dept Oncol, Jonkoping, Sweden
- Andersson, R (author)
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- Johansson, H (author)
- Jonsson, PE (author)
- Lindholm, C (author)
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- (creator_code:org_t)
- 2000
- 2000
- English.
- In: Cancer. - 0008-543X .- 1097-0142. ; 89:7, s. 1495-1501
- Journal article (peer-reviewed)
Abstract
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- BACKGROUND. Large, prospective, randomized trials with long term follow-up are required to obtain an unbiased evaluation of the significance of resection margins in patients with cutaneous melanoma. METHODS, The Swedish Melanoma Study Group performed a prospective, randomized, multicenter study of patients with primary melanoma located on trunk or extremities and with a tumor thickness > 0.8 mm and less than or equal to 2 mm. Patients were allocated randomly to a 2-cm excision margin or a 5-cm excision margin. In total, 989 patients were recruited during the period 1982-1991. The median follow-up, was 11 years (range, 7-17 years) for estimation of survival and 8 years (range, 0-17 years) for evaluation of recurrent disease. RESULTS. The crude rate of local recurrence, defined as a recurrence in the scar or transplant, was < 1% (8 of 989 patients). Twenty percent of the patients (194 of 989 patients) experienced any disease recurrence, and 15% (146 of 989 patients) died of melanoma. There were no statistically significant differences between the two treatment arms. In a multivariate Cox analysis with patients allocated to wide excision as the reference group, the estimated relative hazards for overall survival and recurrence free survival among those allocated to a 2-cm resection margin were 0.96 (95% confidence interval, 0.75-1.24), and 1.02 (95% confidence interval, 0.80-1.30), respectively. CONCLUSIONS. In this long term follow-up study, local recurrences were found to be rare among patients with tumors > 0.8 mm thick and less than or equal to 2.0 mm thick. Mo difference in recurrence rate or survival between the two treatment groups was found. Patients in this category can be treated with a resection margin of 2 cm as safely as with a resection margin of 5 cm. Cancer 2000,89:1495-501. (C) 2000 American Cancer Society.
Keyword
- primary melanoma
- resection margins
- tumor thickness 0.8-2 mm
- randomized study
- long term follow-up
- locoregional recurrence
- survival
- MEDICINE
- MEDICIN
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