Melanoma is fast becoming a growing concern for Ireland. Despite the country’s reputation for overcast skies and a relatively cool climate, the number of melanoma cases is on the rise. Ireland has approximately 1300 new melanoma cases per year, with a projected increase of 207% in males and 140% in females by 2045. This alarming trend can be attributed to a combination of factors including a large population of fair-skinned people, environmental changes, and underestimating the dangers of excessive sun exposure.
Although Ireland only gets around half the amount of sunshine compared with Australia, many Irish people travel to sunnier destinations where exposure to intense UV radiation can significantly increase the risk of developing melanoma later in life.
Despite melanoma excision surgery being regularly performed in Ireland and Australia, each country has different guidelines for the operation. Irish surgeons typically use a 1 – 2 cm excision margin for thicker cutaneous melanomas, while Australian surgeons operating on the same size melanoma may use a 1 cm excision margin.
To help address the urgent need for an international consensus for the surgical treatment of stage II melanoma, Cancer Trials Ireland collaborative group has joined the Australia-led Melanoma Margins Trial, known as ‘MelMarT-II’. Several Irish sites will be involved in this trial, aiming to enrol 120 Irish participants annually. The international trial will study almost 3,000 patients across nine countries, including major coordinating trial centres in Australia, Europe, and North America.
A surgeon’s decision to use either a 1 cm or 2 cm excision margin for stage II melanoma can impact a patient’s quality of life and survival. A larger excision margin can lead to complex surgical reconstruction, poorer cosmetic appearance, post-operative complications, and impact on function. But if the excision margin is too small, the melanoma might return or spread.
The MelMarT-II trial, coordinated by Melanoma and Skin Cancer Trials, will determine whether a 1 cm or a 2 cm margin is best and provide certainty for melanoma patients and their doctors in deciding the most effective treatment.
Principal Investigator from the Mater Misericordiae University Hospital, and University College Dublin, A/Prof Shirley Potter, is leading the MelMarT-II trial’s efforts in Ireland, with support from Cancer Trials Ireland and the Irish Cancer Society.
“We are delighted that Irish melanoma patients will be contributing to this global effort to improve outcomes for stage II melanoma patients. This trial addresses an important unanswered clinical question concerning the surgical management of melanoma. Substantial dedication from Cancer Trials Ireland and the Irish Cancer Society has been invested in the establishment of this surgical trial in Ireland, and we anticipate that it will yield tangible improvements in the quality of life for our Irish melanoma patients.”
Australian Co-Study Chair, Prof Michael Henderson from the Peter MacCallum Cancer Centre in Melbourne said, “This international collaborative effort will provide the high-quality evidence required to update clinical practice for stage II melanoma in Australia and world-wide.”
Prof Marc Moncrieff, the trial’s United Kingdom Co-Study Chair added, “With almost 2,000 patients recruited into the trial already, we are on track to meet our enrolment target by the end of 2024.”
Read more information about the MelMarT-II trial.