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Charles M. Balch, MD; Merrick I. Ross, MD; Natale Cascinelli, MD; Seng-jaw Soong, PhD

Arch Surg. 2007;142(9):891-893.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Collectively, surgeons have incorporated evidence-based practices increasingly over the last decades. The meta-analysis on 5 clinical trials involving melanoma surgical excision margins by Lens et al in this issue of the Archives provides an opportunity to review the evolution of our current standard of care for melanoma surgery and exemplifies a continuing shift from empirically based to evidence-based surgery.

Readers of the Archives might recall that just 25 years ago the standard of care was to excise melanomas with 4-cm to 5-cm radial margins of skin (Yes, that would be 5 to 6 inches across!), with disfiguring, morbid closures and large skin grafts. Historically, the approach of using radical margins has been ascribed to the anecdotal experience of Handley,¹ who in 1907 reported his treatment of locally advanced melanomas and his finding of "centripetal lymphatic spread" . . . [Full Text of this Article]

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Excision Margins for Primary Cutaneous Melanoma: Updated Pooled Analysis of Randomized Controlled Trials
Marko B. Lens, Paul Nathan, and Veronique Bataille
Arch Surg. 2007;142(9):885-891.
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