Similar local recurrence and survival in patients with T1 radial growth phase melanoma on head and neck treated with 5 or 10 mm margins: A retrospective study
Rattachement africain : it, gb, il, us, ch. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Melanoma guidelines recommend surgical excision with 10 mm margins for T1 melanomas (invasive melanomas with Breslow thickness ≤1 mm), including those in radial growth phase, which are without metastatic potential; however, such margins may be problematic on head-and-neck. OBJECTIVE: We compared outcomes of wide (10 mm margins) versus narrow (5 mm margins) excisions in patients with radial growth phase T1 melanoma on head-and-neck including face. METHODS: We retrospectively examined 610 consecutive patients excised with wide versus narrow margins, from 2001 to 2018, at six European centres. In all cases, radial growth phase, and clear margins with 5 or 10 mm of clearance, were ascertained histologically. Multivariable models investigated associations of margins and other factors with overall survival and local recurrence. RESULTS: Three hundred and sixteen (51.8%) patients received wide excision, 219 (69.3%) with primary wound closure, 97 (30.7%) with reconstruction; 294 (48.2%) patients received narrow excision, 264 (89.8%) with primary wound closure, 30 (10.2%) with reconstruction (p < 0.001). Median follow-ups were 88 months (wide) and 187 months (narrow) (inter-quartile ranges 43-133 and 79-206, respectively). Ten-year overall survival (95% confidence interval) was 96.7% (94.2%-99.3%) in wide and 98.2% (96.4%-100%) in narrow patients. Ten-year local recurrence incidence was 6.4% (4.1%-10.1%) in wide and 7.8% (5.3%-11.6%) in narrow groups. Lentigo maligna melanoma subtype appeared associated with increased risk of local recurrence in narrow versus wide patients (15.0% vs. 7.5%; p = 0.190). CONCLUSIONS: Narrower excision margins for T1 radial growth phase melanoma are not associated with worse overall survival (hazard ratio 0.97, p = 0.996) or increased local recurrence (subdistribution hazard ratio: 0.87; p = 0.751) compared to wider margins, and may be safely applied to such lesions, although caution may be required in the presence of lentigo maligna melanoma.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé, mais le titre doit être comparé manuellement.
- Titre Crossref
- Similar local recurrence and survival in patients with<scp>T1</scp>radial growth phase melanoma on head and neck treated with 5 or 10 mm margins: A retrospective study
- Date Crossref
- 27/03/2023
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
Fondazione IRCCS Istituto Nazionale dei Tumori pays non établi dans la noticeÉtablissement de santé
-
Queen Mary University of London pays non établi dans la noticeUniversité ou école supérieure
-
Tel Aviv Sourasky Medical Center Peritoneal Surface Malignancy and Melanoma Unit pays non établi dans la noticeÉtablissement de santé
-
Ospedale Policlinico San Martino Skin Cancer Unit pays non établi dans la noticeÉtablissement de santé
-
European Institute of Oncology pays non établi dans la noticeÉtablissement de santé
-
Brescia University pays non établi dans la noticeUniversité ou école supérieure
-
University of Brescia pays non établi dans la noticeUniversité ou école supérieure
-
University of Modena and Reggio Emilia pays non établi dans la noticeUniversité ou école supérieure
-
Sapienza University of Rome Dermatology Clinic pays non établi dans la noticeUniversité ou école supérieure
-
Ospedale Regionale di Bellinzona e Valli pays non établi dans la noticeÉtablissement de santé
-
Istituto Cantonale di Patologia pays non établi dans la noticeStructure de recherche
-
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico pays non établi dans la noticeÉtablissement de santé
Fondazione IRCCS Istituto Nazionale dei Tumori, Queen Mary University of London et Peritoneal Surface Malignancy and Melanoma Unit — Tel Aviv Sourasky Medical Center, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.