Excisional biopsy and delayed wide excision versus primary wide excision of malignant melanoma.

In a retrospective study of 269 cutaneous malignant melanomas in stage I the influence of biopsy on survival was studied. Sixty patients were treated with primary wide excision and 209 patients with excisional biopsy followed by wide excision. The 5-year survival rates for the two groups were 75.0% and 82.8% respectively. There was an equal distribution of prognostic factors such as thickness, level of invasion, presence of ulceration, location and maximal size of the tumours in the two groups. As excisional biopsy with subsequent wide excision gives an accurate histopathologic diagnosis and permits a more rational treatment of thin melanomas, this form of treatment is recommended.