Mayo Clinic consensus recommendations for the depth of excision in primary cutaneous melanoma

Travis E. Grotz, Svetomir Nenad Markovic, Lori A. Erickson, William S. Harmsen, Marianne Huebner, David R. Farley, Barbara A Pockaj, John H. Donohue, Franklin H. Sim, Clive S. Grant, Sanjay P. Bagaria, Thomas C. Shives, Charles M. Balch, James W Jakub

Research output: Contribution to journalArticle

18 Scopus citations


Currently, no data from randomized controlled clinical trials are available to guide the depth of resection for intermediate-thickness primary cutaneous melanoma. Thus, we hypothesized that substantial variability exists in this aspect of surgical care. We have summarized the literature regarding depth of resection and report the results of our survey of surgeons who treat melanoma. Most of the 320 respondents resected down to, but did not include, the muscular fascia (extremity, 71%; trunk, 66%; and head and neck, 62%). However, significant variation exists. We identified variability in our own practice and have elected to standardize this common aspect of routine surgical care across our institution. In light of the lack of evidence to support resection of the deep muscular fascia, we have elected to preserve the muscular fascia as a matter of routine, except when a deep primary melanoma or thin subcutaneous tissue dictates otherwise.

Original languageEnglish (US)
Pages (from-to)522-528
Number of pages7
JournalMayo Clinic Proceedings
Issue number6
StatePublished - 2011


ASJC Scopus subject areas

  • Medicine(all)

Cite this

Grotz, T. E., Markovic, S. N., Erickson, L. A., Harmsen, W. S., Huebner, M., Farley, D. R., Pockaj, B. A., Donohue, J. H., Sim, F. H., Grant, C. S., Bagaria, S. P., Shives, T. C., Balch, C. M., & Jakub, J. W. (2011). Mayo Clinic consensus recommendations for the depth of excision in primary cutaneous melanoma. Mayo Clinic Proceedings, 86(6), 522-528.