Narrow Excision Margins for Diverse Histological Subtypes of Cutaneous Melanoma in Children and Adults: A Systematic Review.
Narrower lateral margins not linked to worse recurrence or survival in melanoma up to 4 mm Breslow
Narrow Excision Margins for Diverse Histological Subtypes of Cutaneous Melanoma in Children and Adults: A Systematic Review.
Wide local excision (wide local excision) is a standard component of cutaneous melanoma management, although prospective evidence supporting current margin recommendations remains limited.
We systematically reviewed relevant published studies up to and including December 2025 to compare local recurrence and survival outcomes between standard wide local excision and no or narrow-margin excisions.
Two retrospective studies reported no significant differences in local recurrence or overall survival (OS) in patients who did not undergo wide local excision (n = 453).
Collectively, these studies suggest that narrower margins than those currently recommended are not associated with worse local recurrence, disease-free survival, or OS for melanoma in situ and T1-pT3 tumors (Breslow index ≤ 4 mm).
However, findings for T4 melanomas (Breslow index > 4 mm) remain inconsistent.
Current evidence suggests that narrower lateral margins and shallower deep excision strategies could be oncologically safe.
However, the absence of an observed association with higher rates of local recurrence or worse survival outcome should not be interpreted as proof of non-inferiority to standard wide local excision, given the predominance of observational data, heterogeneity across studies, and limited statistical power in smaller cohorts.
High-quality prospective randomized trials are required.