Association between excision margins and local recurrence in 1407 patients with primary in situ melanomasCapsule Summary

Licata Gaetano, MD; Birra Domenico, MD; Serigne N. Lo, PhD; Tasnia Hamed, MS; Alison J. Potter, MD; John F. Thompson, MD; Richard A. Scolyer, MD; Pascale Guitera, MD, PhD

JAAD International (Sep 2022)

Association between excision margins and local recurrence in 1407 patients with primary in situ melanomasCapsule Summary

Licata Gaetano, MD,
Birra Domenico, MD,
Serigne N. Lo, PhD,
Tasnia Hamed, MS,
Alison J. Potter, MD,
John F. Thompson, MD,
Richard A. Scolyer, MD,
Pascale Guitera, MD, PhD

Affiliations

Licata Gaetano, MD: Dermatology Unit- University of Campania “Luigi Vanvitelli”, Naples, Italy
Birra Domenico, MD: UOC Internal Medicine, Rheumatology Outpatient Unit, Azienda Ospedaliero-Universitaria San Giovanni di Dio e Ruggi D’Aragona, Salerno, Italy
Serigne N. Lo, PhD: Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia; The Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
Tasnia Hamed, MS: Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
Alison J. Potter, MD: Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia; The Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, New South Wales, Australia
John F. Thompson, MD: Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia; The Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, New South Wales, Australia
Richard A. Scolyer, MD: Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia; The Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
Pascale Guitera, MD, PhD: Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia; The Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Correspondence to: Pascale Guitera, MD, PhD, Melanoma Institute Australia, The University of Sydney, 40 Rocklands Rd, North Sydney, New South Wales, 2060, Australia.

Journal volume & issue: Vol. 8
pp. 102 – 108

Abstract

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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 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.

Published in JAAD International

ISSN: 2666-3287 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Dermatology
Website: https://www.journals.elsevier.com/jaad-international

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