Results of 3 cm excision margin for melanoma of the scalp
Hudson, D.A.; Krige, J.E.
Journal of the Royal College of Surgeons of Edinburgh 40(2): 93-96
1995
ISSN/ISBN: 0035-8835 PMID: 7776282 Document Number: 451413
Local recurrence and survival were evaluated in 19 patients with melanoma of the scalp after conservative local treatment using a standard protocol of 3 cm excision margins and split skin grafting. Sixteen men and three women had a mean age of 46 years. 12 presented with stage I disease, one with stage II, five with stage III, and one with stage IV disease. Nodular melanoma was present in 16 patients. 17 patients had either Clark level IV or V lesions and mean Breslow depth was 3.4 mm (range 0.9-25). Local recurrence occurred in only one patient who had an excision biopsy performed. Six of 12 patients with stage I disease developed regional adenopathy and only 2 are alive after therapeutic block dissection. All patients with stage III and stage IV disease have died. Excision using 3 cm margin is adequate to control local disease. Scalp melanoma is a specific anatomical subsite associated with a high incidence of regional disease and has a poor prognosis. This high risk group of patients may benefit from elective lymph node dissection.