Utjés D, et al. - Researchers report the extended follow-up of a multicenter, randomized controlled trial to determine the optimal surgical excision margins for patients with thick (>2 mm) localized cutaneous melanomas. Overall 936 clinically staged patients were recruited from 53 hospitals in Sweden, Denmark, Estonia, and Norway. Patients were aged 75 years or younger, were diagnosed with localized cutaneous melanoma thicker than 2 mm, and had lesions on the trunk or upper or lower extremities as primary sites. Randomly, patients were assigned (1:1) to treatment either with a 2-cm (n=471) or a 4-cm excision margin (n=465). A total of 621 deaths were documented, with 304 (49%) in the 2-cm group and 317 (51%) in the 4-cm group after a median follow-up of 19.6 years. In this study, the safety of a 2-cm excision margin for patients with thick (>2 mm) localized cutaneous melanoma was evident and therefore, its use in current clinical practice is supported.