Do you always excise down to the fascia when treating invasive melanomas and does body site location influence the depth of excision?

This a great question.

Recommendations for the width and depth of cutaneous melanoma excisions aim to prevent local and satellite/in-transit recurrence. Results of randomized controlled trials (RCT) currently guide the recommendations for the width of excision, however, RCTs that evaluate the ideal depth of excision for thin invasive or intermediate-thickness melanoma are not available.

The current recommendation for the depth of excision for invasive melanoma by the National Comprehensive Cancer Network (NCCN) version 2.2023 is for “excision of all the tissue to the level of the fascia, which is typically preserved unless involved by tumor.” The American College of Surgeons recommends that the “depth of the resection should include the skin ...