Melanoma: Surgical management recommendations

  • Treatment of choice for primary cutaneous melanoma of any thickness is surgical excision with histologically negative margins. 
  • Surgical margins for invasive melanoma should be at least 1 cm and no more than 2 cm clinically measured around primary tumor; clinically measured surgical margins do not need to correlate with histologically negative margins.
  • For melanoma in situ, wide excision with 0.5- to 1.0-cm margins is recommended; lentigo maligna histologic subtype may require >0.5-cm margins to achieve histologically negative margins, because of characteristically broad subclinical extension.

Surgical margin recommendations for primary cutaneous melanoma

Tumor Thickness     Clinically Measured 
Surgical Margin 
Strength of
 Level of 
In situ 0.5 - 1.0 cm   C  III
≤ 1.0 mm
1 cm   A  I
1.01 - 2.0 mm 1 - 2 cm   A  I
≥ 2.0 mm 2 cm   B  I,II,III

Strength of Recommendations: A,B,C Level of Evidence: I,II,II

View the AAD guidelines disclaimer.