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Narrow-Margin Excision for Invasive Acral Melanoma: Is It Acceptable?
In this retrospective review of 100 patients with primary invasive acral melanoma, we examined whether narrow-margin excision is warranted for acral melanoma. Patients treated with surgical margins recommended by the National Comprehensive Cancer Network (R-group) were compared to those treated with...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408916/ https://www.ncbi.nlm.nih.gov/pubmed/32708762 http://dx.doi.org/10.3390/jcm9072266 |
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author | Ito, Takamichi Kaku-Ito, Yumiko Wada-Ohno, Maiko Furue, Masutaka |
author_facet | Ito, Takamichi Kaku-Ito, Yumiko Wada-Ohno, Maiko Furue, Masutaka |
author_sort | Ito, Takamichi |
collection | PubMed |
description | In this retrospective review of 100 patients with primary invasive acral melanoma, we examined whether narrow-margin excision is warranted for acral melanoma. Patients treated with surgical margins recommended by the National Comprehensive Cancer Network (R-group) were compared to those treated with narrow margins (N-group). A total of 65 patients underwent narrow-margin excision. Positive margin status or local recurrence rarely occurred regardless of the excision margins, whereas fatal events frequently occurred, particularly among the patients with T4 melanoma. The mortality rates of N- and R-group with T1–3 melanomas were similar (1.36 and 1.28 per 100 person-years, respectively). However, patients with T4 melanoma treated with narrow-margin excision had a higher mortality rate (11.44 vs. 5.03 per 100 person-years). Kaplan–Meier analyses showed a worse prognosis in the N-group (p = 0.045) but this group had thicker Breslow thickness (4.21 mm vs. 2.03 mm, p = 0.0013). A multivariate analysis showed that Breslow thickness was an independent risk factor, but surgical margin was not a risk factor for melanoma-specific survival or disease-free survival. In conclusion, although we could not find a difference between the narrow-margin excision and recommended-margin excision in this study, we suggest following current recommendations of guidelines. Our study warrants the prospective collection of data on acral melanoma to better define the prognosis of this infrequent type of melanoma. |
format | Online Article Text |
id | pubmed-7408916 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-74089162020-08-13 Narrow-Margin Excision for Invasive Acral Melanoma: Is It Acceptable? Ito, Takamichi Kaku-Ito, Yumiko Wada-Ohno, Maiko Furue, Masutaka J Clin Med Article In this retrospective review of 100 patients with primary invasive acral melanoma, we examined whether narrow-margin excision is warranted for acral melanoma. Patients treated with surgical margins recommended by the National Comprehensive Cancer Network (R-group) were compared to those treated with narrow margins (N-group). A total of 65 patients underwent narrow-margin excision. Positive margin status or local recurrence rarely occurred regardless of the excision margins, whereas fatal events frequently occurred, particularly among the patients with T4 melanoma. The mortality rates of N- and R-group with T1–3 melanomas were similar (1.36 and 1.28 per 100 person-years, respectively). However, patients with T4 melanoma treated with narrow-margin excision had a higher mortality rate (11.44 vs. 5.03 per 100 person-years). Kaplan–Meier analyses showed a worse prognosis in the N-group (p = 0.045) but this group had thicker Breslow thickness (4.21 mm vs. 2.03 mm, p = 0.0013). A multivariate analysis showed that Breslow thickness was an independent risk factor, but surgical margin was not a risk factor for melanoma-specific survival or disease-free survival. In conclusion, although we could not find a difference between the narrow-margin excision and recommended-margin excision in this study, we suggest following current recommendations of guidelines. Our study warrants the prospective collection of data on acral melanoma to better define the prognosis of this infrequent type of melanoma. MDPI 2020-07-16 /pmc/articles/PMC7408916/ /pubmed/32708762 http://dx.doi.org/10.3390/jcm9072266 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ito, Takamichi Kaku-Ito, Yumiko Wada-Ohno, Maiko Furue, Masutaka Narrow-Margin Excision for Invasive Acral Melanoma: Is It Acceptable? |
title | Narrow-Margin Excision for Invasive Acral Melanoma: Is It Acceptable? |
title_full | Narrow-Margin Excision for Invasive Acral Melanoma: Is It Acceptable? |
title_fullStr | Narrow-Margin Excision for Invasive Acral Melanoma: Is It Acceptable? |
title_full_unstemmed | Narrow-Margin Excision for Invasive Acral Melanoma: Is It Acceptable? |
title_short | Narrow-Margin Excision for Invasive Acral Melanoma: Is It Acceptable? |
title_sort | narrow-margin excision for invasive acral melanoma: is it acceptable? |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408916/ https://www.ncbi.nlm.nih.gov/pubmed/32708762 http://dx.doi.org/10.3390/jcm9072266 |
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