Clinicopathologic factors, especially location in cosmetically or functionally sensitive areas and noncompliance with recommended surgical margins, identified melanomas at increased risk for positive or equivocal margins after wide local excision (WLE), a recent study found. Researchers conducted a retrospective, single-center, cross-sectional study of 1,345 consecutive melanomas treated with WLE. They found:

• The overall frequency of positive or equivocal margins was 4.2% (56/1345), ranging from 2.2% to 22.6%, depending on the size of the surgical margins, patient characteristics, biopsy history, and the clinicopathology of the melanoma.
• In descending order, independent risk factors associated with the greatest odds for positive or equivocal margins after multivariate analysis were noncompliance with recommended surgical margins; anatomic location on the head, neck, hands, feet, genitals, or pretibial leg; histologic regression; in situ melanoma; multiple biopsies at the tumor site before WLE; and increasing age.