黑色素瘤活检切缘呈阳性可能会引起人们对因延迟手术切除而导致的潜在疾病进展的焦虑，但其对结果的影响尚不清楚。我们的目的是比较手术切除标本中残留黑色素瘤的存在情况以及活检切缘阴性、镜下阳性和宏观阳性患者之间的生存率。纳入了 13 年以上接受手术切除的皮肤黑色素瘤患者。比较了活检边缘阴性、镜下阳性（仅可见疤痕）和宏观阳性（可见残留黑色素瘤）活检边缘患者的活检特征、手术标本中的残留疾病以及总体生存率和无复发生存率。在 901 名患者中，42.4%分别有 33.3% 和 24.3% 的切缘为阴性、显微镜下阳性和宏观上阳性。手术标本中残留浸润性黑色素瘤的发生率各不相同（P<0.001），分别发生在 5.5%、17.0% 和 74.9% 的患者中。微观和宏观切缘阳性均与残留病灶相关（P < 0.001），但只有后者预测总体较差（P = 0.013）和无复发生存率（P = 0.009）。 Kaplan-Meier 估计切缘阴性组和镜下切缘阳性组的生存率相当，但总体（P = 0.006）和无复发生存期（P = 0.004）在肉眼切缘阳性组中显着较差。这些患者的黑色素瘤预后较差，其中 33.8% 为 III 期疾病，23.2% 的前哨淋巴结阳性。患者和医生可以放心，镜下活检切缘呈阳性，这与较差的生存率无关，但是，宏观切缘阳性预后较差，应在可接受的时间范围内进行治疗。© 2024。外科肿瘤学会。

Presence of positive biopsy margins in melanoma can provoke anxiety over potential disease progression from delays to surgical excision, but their impact on outcomes is unknown. We aimed to compare the presence of residual melanoma in the surgical excision specimen and survival between patients with negative, microscopically positive, and macroscopically positive biopsy margins.Patients with cutaneous melanoma who underwent surgical excision over a 13-year period were included. Biopsy characteristics, residual disease in the surgical specimen, and overall and recurrence-free survival were compared between patients with negative, microscopically positive (only scar visible), and macroscopically positive (visible remaining melanoma) biopsy margins.Of 901 patients, 42.4%, 33.3%, and 24.3% had negative, microscopically positive, and macroscopically positive margins, respectively. The incidence of residual invasive melanoma in the surgical specimen varied (P < 0.001), occurring in 5.5%, 17.0%, and 74.9% of patients, respectively. Both microscopically and macroscopically positive margins were associated with residual disease (P < 0.001) but only the latter predicted worse overall (P = 0.013) and recurrence-free survival (P = 0.009). Kaplan-Meier estimated survival was comparable between those with negative and microscopically positive margins, but overall (P = 0.006) and recurrence-free survival (P = 0.004) were significantly worse in the macroscopically positive margin group. These patients had worse prognosis melanoma, with 33.8% being stage III disease, and 23.2% having positive sentinel lymph nodes.Patients and physicians may be reassured in the presence of microscopically positive biopsy margins which are not associated with worse survival, However, patients with macroscopically positive margins have poorer prognosis and should be treated within an acceptable time frame.© 2024. Society of Surgical Oncology.