NCT06363591

Brief Summary

The overall aim of this national, multicenter, prospective, randomized, and controlled study is to enhance the management of patients with thin melanoma (≤1 mm Breslow thickness). The investigators hypothesize that wide local excisions (WLEs) following complete excision of thin melanoma do not affect the risk of recurrence, defined as the occurrence of local, regional, distant disease, or melanoma-specific death during a 5- to 10-year follow-up period.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
2,486

participants targeted

Target at P75+ for not_applicable

Timeline
166mo left

Started Jan 2025

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress9%
Jan 2025Dec 2039

First Submitted

Initial submission to the registry

March 28, 2024

Completed
15 days until next milestone

First Posted

Study publicly available on registry

April 12, 2024

Completed
10 months until next milestone

Study Start

First participant enrolled

January 22, 2025

Completed
9.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2034

Expected
5 years until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2039

Last Updated

March 5, 2025

Status Verified

January 1, 2025

Enrollment Period

9.9 years

First QC Date

March 28, 2024

Last Update Submit

February 28, 2025

Conditions

Keywords

MelanomaSurgeryWide local excisionRecurrenceMetastasisDeath

Outcome Measures

Primary Outcomes (1)

  • Recurrence rate at 5 years.

    Recurrence is defined as any presence of local/regional/distant disease or melanoma-specific death.

    5 years

Secondary Outcomes (1)

  • Recurrence rate at 10 years.

    10 years

Other Outcomes (13)

  • Postoperative complications

    3 months

  • Scar length, width and quality

    1 year

  • Scar length, width and quality

    3 years

  • +10 more other outcomes

Study Arms (2)

Wide - With wide local excision - Control group

OTHER

Standard treatment with a wide local excision (i.e. reexcision of the diagnostic excision scar with a lateral clinical surgical margin of 10 mm and a deep clinical surgical margin down to the muscular fascia as recommended by the Swedish national guidelines).

Procedure: Surgery

Wise - Without wide local excision - Experimental group

EXPERIMENTAL

No wide local excision.

Other: No Surgery

Interventions

SurgeryPROCEDURE

Wise or wide excision

Wide - With wide local excision - Control group

No wide local excision

Wise - Without wide local excision - Experimental group

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients need to fulfill all criteria listed below:
  • Has recently been diagnosed with a primary invasive cutaneous melanoma of Breslow thickness ≤1.0 mm (pT1) as determined by a diagnostic excision with subsequent histopathological analysis that:
  • Is located on a body location in which a WLE with a 10-mm clinical margin is feasible and would have been planned according to current standard of care.
  • Had histopathologically verified free margins of at least 1.5 mm.
  • Is 18 years or older at time of consent.
  • Is able to give informed consent and comply with the treatment protocol and follow-up plan.
  • Has a life expectancy of ≥5 years from the time of diagnosis.

You may not qualify if:

  • If any of the listed criteria below are present, the patient is ineligible for study participation.
  • The study lesion:
  • was partially biopsied prior to the diagnostic excision.
  • was diagnostically excised with a clinical margin \>5 mm.
  • was a melanoma of desmoplastic or lentiginous (i.e. lentigo maligna or acral lentiginous) subtype.
  • was located on digits in which amputation is necessary.
  • The patient:
  • had a previous or concurrent MIS or invasive melanoma (cutaneous or non-cutaneous).
  • had physical, clinical, radiographic or pathologic evidence of microsatellite, satellite, in-transit, regional or distant metastatic melanoma.
  • had a previous or intercurrent treated solid tumor or hematologic malignancy during the past 5 years except cutaneous squamous cell carcinoma or basal cell carcinoma.
  • has planned adjuvant radiotherapy to the primary melanoma site after WLE.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Sahlgrenska University Hospital

Gothenburg, 41345, Sweden

RECRUITING

Related Publications (1)

  • Wennberg E, Claeson M, Olofsson Bagge R, Polesie S, Paoli J. Wise or wide (WoW) study protocol: a national, multicentre, prospective, randomised and controlled, parallel group, non-inferiority study to compare single-staged versus two-staged excisions of thin invasive (</=1.0 mm) melanoma. BMJ Open. 2025 Apr 2;15(4):e094544. doi: 10.1136/bmjopen-2024-094544.

MeSH Terms

Conditions

MelanomaRecurrenceNeoplasm MetastasisDeath

Interventions

Surgical Procedures, Operative

Condition Hierarchy (Ancestors)

Neuroendocrine TumorsNeuroectodermal TumorsNeoplasms, Germ Cell and EmbryonalNeoplasms by Histologic TypeNeoplasmsNeoplasms, Nerve TissueNevi and MelanomasSkin NeoplasmsNeoplasms by SiteSkin DiseasesSkin and Connective Tissue DiseasesDisease AttributesPathologic ProcessesPathological Conditions, Signs and SymptomsNeoplastic Processes

Study Officials

  • John Paoli, Professor

    Dept. of Dermatology and Venereology, Sahlgrenska Academy, University of Gothenburg, Sweden

    PRINCIPAL INVESTIGATOR

Central Study Contacts

John Paoli, Professor

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Patients with thin (≤1.0 mm) invasive melanomas excised with a histopathological margin ≥1.5 mm will be offered to participate following informed consent and randomization (1:1) to either: 1. Standard treatment with a WLE of the diagnostic excision scar with a lateral clinical surgical margin of 10 mm and a deep clinical surgical margin down to the muscular fascia as recommended by the Swedish national guidelines. or 2. Experimental treatment with no WLE.
Sponsor Type
OTHER GOV
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 28, 2024

First Posted

April 12, 2024

Study Start

January 22, 2025

Primary Completion (Estimated)

December 31, 2034

Study Completion (Estimated)

December 31, 2039

Last Updated

March 5, 2025

Record last verified: 2025-01

Data Sharing

IPD Sharing
Will share

De-identified individual participant data will be shared upon reasonable request.

Shared Documents
STUDY PROTOCOL, SAP, ICF, CSR
Time Frame
Data will be available 6 months after publication of study results (start date) and 1 year after this (end date).
Access Criteria
Data will be shared upon reasonable request and accessed by contacting john.paoli@gu.se.
More information

Locations