Excision margins for melanoma in situ on the head and neck-A single-center 10-year retrospective review of treatment with Mohs micrographic surgery.

Autor: Tate JA; Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas., Matsumoto A; Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas., Greif C; University of Texas Southwestern School of Medicine, Dallas, Texas., Lim J; University of Texas Southwestern School of Medicine, Dallas, Texas., Nijhawan RI; Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas., Srivastava D; Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: divya.srivastava@utsw.edu.
Jazyk: angličtina
Zdroj: Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2024 Jun; Vol. 90 (6), pp. 1226-1231. Date of Electronic Publication: 2024 Jan 20.
DOI: 10.1016/j.jaad.2023.12.063
Abstrakt: Background: Although current guidelines recommend a 5 mm surgical margin for the excision of melanoma in situ (MIS), increasing evidence has shown this may be suboptimal to achieve tumor clearance.
Objective: To evaluate margins required for optimal cure rates with excision of MIS on the head and neck and investigate tumor and/or patient factors in those requiring >5 mm margins to achieve tumor clearance.
Methods: A retrospective chart review was performed on 846 (807 primary and 39 recurrent) MIS cases on the head and neck treated in the authors' dermatologic surgery department over a 126-month (10.5 year) period.
Results: Sixty-two percent were cleared with 5 mm margins. A total of 15 mm margins were required to achieve a 97% clearance rate. Difference in clearance rate between margin thresholds was significant (P < .001). Tumor location on the cheek and larger preoperative size correlated with requiring >5 mm margins to achieve tumor clearance (P = .006 and P = .001, respectively).
Limitations: This is a single-center retrospective study which relies on accurate documentation of clinical data.
Conclusion: This study demonstrates that MIS on the head and neck often requires margins >5 mm margins to achieve tumor clearance. When Mohs micrographic surgery is not possible, excision margins of ≥10 mm are likely necessary for head and neck tumors.
Competing Interests: Conflicts of interest None disclosed.
(Copyright © 2024 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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