| Autor: |
Xu YG; 1Department of Dermatology, University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI., Lim Y; 2Department of Dermatology, Havard Medical School, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA., Bordeaux JS; 3Department of Dermatology, Case Comprehensive Cancer Center/University Hospitals Cleveland Medical Center, Cleveland, OH., Aasi SZ; 4Department of Dermatology, Stanford Cancer Institute, Stanford, CA., Alam M; 5Department of Dermatology and Otolaryngology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL., Chen PL; 6Department of Pathology, Moffitt Cancer Center, Tampa, FL., Contreras CM; 7Department of Surgical Oncology, The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute, Columbus, OH., DiMaio D; 8Department of Pathology, Fred & Pamela Buffett Cancer Center, Omaha, NE., Donigan JM; 9Department of Dermatology, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT., Farma JM; 10Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA., Grekin RC; 11Department of Dermatology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA., Mark L; 12Department of Dermatology, Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN., Nehal KS; 13Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY., Nghiem P; 14Department of Dermatology, Fred Hutchinson Cancer Center/University of Washington, Seattle, WA., Olino K; 15Department of Surgical Oncology, Yale Cancer Center/Smilow Cancer Hospital, New Haven, CT., Patel T; 16Department of Dermatology and Pathology, University of Tennessee Health Science Center, Memphis, TN., Scott J; 17Department of Dermatology, Clinical Skin Center, Fairfax, VA., Shaha AR; 13Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY., Srivastava D; 18UT Southwestern Simmons Comprehensive Cancer Center, Dallas, TX., Schmults CD; 2Department of Dermatology, Havard Medical School, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA. |
| Abstrakt: |
Peripheral and deep en face margin assessment (PDEMA), formerly termed by NCCN as complete circumferential peripheral and deep margin assessment (CCPDMA), has the advantages of histologic visualization of the entire marginal surface, highly accurate resection of involved tissue, and sparing of uninvolved tissue. Owing to its highest reported cure rates, PDEMA is the NCCN-preferred treatment for dermatofibrosarcoma protuberans, high-risk basal cell carcinoma, and very-high-risk cutaneous squamous cell carcinoma. In the United States, Mohs micrographic surgery (Mohs) is the most common method of PDEMA. In Germany and some other countries, non-Mohs methods of PDEMA referred to as the Tubingen torte and muffin techniques are more widely used. The Tubingen methods of PDEMA require close communication between surgeon and pathologist. This article describes the background of both Mohs and Tubingen PDEMA, reviews what constitutes PDEMA, and provides a protocol for Tubingen PDEMA detailing critical components in a stepwise fashion using illustrative photos and diagrams. We hope to broaden understanding of the NCCN Guidelines and their rationale, align practice, and optimize patient outcomes. |
