{"entity":{"id":"wide-local-excision","kind":"term","name":"Wide local excision","aka":["wide excision","excision margins","local excision","re-excision","re-excisions"],"tldr":"Cutting out a tumour together with a measured rim of normal-looking tissue around it, so that microscopic spread at the edge is removed too.","summary":"The standard treatment for primary melanoma after diagnostic biopsy: margins of 0.5 cm for in situ, 1 cm for tumours ≤1 mm and 2 cm for thicker tumours (MSLT, MelMarT trials). The same principle applies to soft-tissue sarcomas, skin cancers, breast lumpectomy and vulval cancer. Wider is not better beyond the evidence-based margin; what matters is that the pathologist finds the edges clear (R0).","asOf":"2026-09-09","wikipedia":"https://en.wikipedia.org/wiki/Wide_local_excision","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Wide_local_excision"},{"label":"Thomson et al., interventions for basal cell carcinoma of the skin: Cochrane review of 52 randomised trials and 6,690 participants (2020)","url":"https://doi.org/10.1002/14651858.CD003412.pub3"},{"label":"Williams et al., surgery versus 5% imiquimod for nodular and superficial basal cell carcinoma, 5-year results of the SINS randomised controlled trial (J Invest Dermatol 2017)","url":"https://doi.org/10.1016/j.jid.2016.10.019"},{"label":"Cancer Research UK: types of surgery for non-melanoma skin cancer","url":"https://www.cancerresearchuk.org/about-cancer/skin-cancer/treatment/surgery/treatment-surgery-types"},{"label":"British Association of Dermatologists: basal cell carcinoma, patient information leaflet (updated July 2025)","url":"https://www.skinhealthinfo.org.uk/condition/basal-cell-carcinoma/"}],"tags":[],"related":["resection-margins","mohs-surgery","breslow-thickness"],"cancers":["melanoma","sarcoma","skin-cancer","basal-cell-carcinoma","cutaneous-scc"],"sections":["surgery"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":["Keratinocyte skin cancer, the comparison that matters. The Cochrane review of 52 randomised trials and 6,690 participants concluded that surgical interventions have the lowest recurrence rates, and that non-surgical treatments used for low-risk basal cell carcinoma are less effective than surgical ones although their recurrence rates are acceptable and their cosmetic outcomes are probably superior. The quantified version: imiquimod cream against excision at low-risk sites gave recurrence of 16.4 percent against 1.6 percent at three years and 17.5 percent against 2.3 percent at five years.","Cancer Research UK describes what a small excision involves in practice: local anaesthetic, removal of the whole abnormal area with a healthy margin, stitches, a dressing, removal of non-dissolvable stitches after one or two weeks at the GP surgery, and the possibility of further surgery if the pathologist finds the margin is not wide enough. For larger cancers it may be a general anaesthetic and a graft or a flap."],"category":"Procedures"},"route":"/terms/wide-local-excision/","neighbours":{"term":[{"id":"breslow-thickness","kind":"term","name":"Breslow thickness","route":"/terms/breslow-thickness/"},{"id":"curettage-and-cautery","kind":"term","name":"Curettage and cautery","route":"/terms/curettage-and-cautery/"},{"id":"limb-salvage-term","kind":"term","name":"Limb-salvage surgery","route":"/terms/limb-salvage-term/"},{"id":"mohs-surgery","kind":"term","name":"Mohs surgery","route":"/terms/mohs-surgery/"},{"id":"resection-margins","kind":"term","name":"Resection margins (R0 / R1 / R2)","route":"/terms/resection-margins/"},{"id":"skin-graft-and-flap-reconstruction","kind":"term","name":"Skin grafts and flaps after skin cancer surgery","route":"/terms/skin-graft-and-flap-reconstruction/"},{"id":"skin-cancer-high-risk-features","kind":"term","name":"What makes a skin cancer high risk: the UK feature lists","route":"/terms/skin-cancer-high-risk-features/"}],"cancer":[{"id":"acral-melanoma","kind":"cancer","name":"Acral melanoma","route":"/cancers/acral-melanoma/"},{"id":"basal-cell-carcinoma","kind":"cancer","name":"Basal cell carcinoma","route":"/cancers/basal-cell-carcinoma/"},{"id":"bowens-disease","kind":"cancer","name":"Bowen's disease (squamous cell carcinoma in situ)","route":"/cancers/bowens-disease/"},{"id":"cutaneous-scc","kind":"cancer","name":"Cutaneous squamous cell carcinoma","route":"/cancers/cutaneous-scc/"},{"id":"dermatofibrosarcoma-protuberans","kind":"cancer","name":"Dermatofibrosarcoma protuberans","route":"/cancers/dermatofibrosarcoma-protuberans/"},{"id":"melanoma","kind":"cancer","name":"Melanoma","route":"/cancers/melanoma/"},{"id":"mucosal-melanoma","kind":"cancer","name":"Mucosal melanoma","route":"/cancers/mucosal-melanoma/"},{"id":"sarcoma","kind":"cancer","name":"Sarcomas (soft tissue, bone, GIST)","route":"/cancers/sarcoma/"},{"id":"skin-cancer","kind":"cancer","name":"Skin cancer (all types)","route":"/cancers/skin-cancer/"},{"id":"stage-ii-melanoma","kind":"cancer","name":"Stage IIB and IIC melanoma","route":"/cancers/stage-ii-melanoma/"},{"id":"stage-iii-melanoma","kind":"cancer","name":"Stage III melanoma (after surgery)","route":"/cancers/stage-iii-melanoma/"}],"section":[{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}]}}