{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:00:07Z","timestamp":1777694407103,"version":"3.51.4"},"reference-count":34,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T00:00:00Z","timestamp":1660521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30CA014236"],"award-info":[{"award-number":["P30CA014236"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although adult guidelines are often applied to children, age\u2010specific surgical margins have not been defined for pediatric melanoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Patients &lt;20\u00a0years of age with invasive, cutaneous melanoma were identified using the 2004\u20132016 National Cancer Database and categorized as undergoing wide (&gt;1\u00a0cm) or narrow (\u22641\u00a0cm) excision. Unadjusted overall survival (OS) was compared using the Kaplan\u2013Meier method and log\u2010rank test. Multivariable Cox proportional hazard models were used to estimate the effect of excision margin on OS after adjustment for available covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 2081 patients met study criteria: 1338 (64.3%) patients underwent wide excision whereas 743 (35.7%) underwent narrow excision. Unadjusted OS was improved in the narrow\u2010excision group (log\u2010rank <jats:italic>p<\/jats:italic>\u00a0=\u00a0.01), which was consistent among patients with thicker (&gt;1\u00a0mm) and thinner (\u22641\u00a0mm) tumors. After adjustment for patient and tumor characteristics, we found no evidence of a difference in OS for patients who underwent narrow excision compared to patients who underwent wide excision (adjusted hazard ratio 0.57, 95% confidence interval 0.32\u20131.01, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.053). There was no interaction between excision margin width and Breslow depth (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.85), indicating that the effect of excision margin width on OS does not differ based on Breslow depth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this analysis, wide excision (&gt;1\u00a0cm) does not appear to be associated with improved survival in children with melanoma regardless of tumor characteristics. Although further studies are needed to define optimal excision margins in pediatric melanoma, this study suggests that more narrow margins (\u22641\u00a0cm) may be acceptable.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.29884","type":"journal-article","created":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T13:15:15Z","timestamp":1660569315000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Examining the role of wide excision margins in pediatric melanoma: A National Cancer Database analysis"],"prefix":"10.1002","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0404-214X","authenticated-orcid":false,"given":"Norma E.","family":"Farrow","sequence":"first","affiliation":[{"name":"Department of Surgery Duke University Medical Center  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jina","family":"Kim","sequence":"additional","affiliation":[{"name":"Inova Fairfax Hospital  Falls Church Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Wolf","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha M.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute  Durham North Carolina USA"},{"name":"Department of Biostatistics &amp; Bioinformatics Duke University  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0803-0218","authenticated-orcid":false,"given":"Lindsay","family":"Olson","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul J.","family":"Mosca","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute  Durham North Carolina USA"},{"name":"Division of Surgical Oncology Department of Surgery Duke University Medical Center  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgia M.","family":"Beasley","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute  Durham North Carolina USA"},{"name":"Division of Surgical Oncology Department of Surgery Duke University Medical Center  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth T.","family":"Tracy","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute  Durham North Carolina USA"},{"name":"Division of Pediatric Surgery Department of Surgery Duke University Medical Center  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-2520"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.11-6-590"},{"key":"e_1_2_10_4_1","unstructured":"RiesLAG SmithMA GurneyJG et\u00a0al. eds.Cancer incidence and survival among children and adolescents: United States SEER program 1975\u20131995. 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