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Association between excision margins and local recurrence in 1407 patients with primary in situ melanomas
BACKGROUND: Reliable evidence to guide the management of melanoma in situ (MIS) and minimize the risk of recurrence is lacking. OBJECTIVE: To identify clinicopathological predictors of local recurrence (LR) in patients with MIS and evaluate long-term outcomes according to pathological excision margi...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9305371/ https://www.ncbi.nlm.nih.gov/pubmed/35875393 http://dx.doi.org/10.1016/j.jdin.2022.06.001 |
Sumario: | BACKGROUND: Reliable evidence to guide the management of melanoma in situ (MIS) and minimize the risk of recurrence is lacking. OBJECTIVE: To identify clinicopathological predictors of local recurrence (LR) in patients with MIS and evaluate long-term outcomes according to pathological excision margins. METHODS: A case-control study of patients with MIS treated at a large Australian melanoma treatment center from January 2008 to December 2012 was undertaken. Clinicopathological characteristics of patients who developed LR and those who did not were compared. RESULTS: LR developed in 34 of 1407 patients with MIS (2.5%). Median time to LR was 20 months. The primary lesion was removed with pathological margins <4 mm (P < .001) in 67.6 % of patients with LR. Four patients died of metastatic melanoma following LR. Comparing patients with pathological margins <4 mm and ≥4 mm, the former were older (>60y, P < .001), more frequently had MIS on the head or neck (P < .001), had a greater LR rate (P < .001), and had a higher mortality from all causes (P < .001). LIMITATIONS: Retrospective, single-institution study. CONCLUSIONS: Pathological margins of ≥4 mm should be considered for patients with MIS who are treated with standard surgical excision and assessed by examining serial slices taken from the formalin-fixed, paraffin-embedded specimen. |
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