END FOR WIDE LOCAL EXCISIONS?

End for Wide Local Excision?

In the journal article referenced below, the authors argue that the current two-step surgical approach for treating cutaneous melanoma, which involves an initial diagnostic excision followed by Wide Local Excision (WLE), may no longer be necessary.

WLE aims to remove potential microscopic melanoma cells around the tumour to prevent recurrence.  There is no strong evidence that WLE improves overall survival compared to just a complete diagnostic excision.  Studies show a low chance (0-4.2%) of finding melanoma cells in the tissue removed during WLE.

WLE can cause significant scarring and other complications.  Advancements in systemic therapy for melanoma may make WLE unnecessary.

Eur J Cancer.2023 Jan:178:82-87.