| Autor: |
Joy H. Kunishige, David G. Brodland, John A. Zitelli |
| Rok vydání: |
2012 |
| Předmět: |
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| Zdroj: |
Journal of the American Academy of Dermatology. 66:438-444 |
| ISSN: |
0190-9622 |
| Popis: |
Background A controversy in the treatment of melanoma in situ is the required width of surgical margin. The currently accepted 5-mm margin is based on a 1992 consensus opinion, despite data since then showing this is inadequate. Objective We sought to develop guidelines for predetermined surgical margins for excision of melanoma in situ. Methods A prospectively collected series of 1072 patients with 1120 melanoma in situs was studied. All lesions were excised by Mohs micrographic surgery with frozen-section examination of the margin. The minimal surgical margin was 6 mm, and the total margin was calculated by adding an additional 3 mm for each subsequent stage required. The minimum surgical margin that would successfully remove 97% of all tumors was calculated. Local recurrence was also tabulated. Results In all, 86% of melanoma in situs were successfully excised with a 6-mm margin; 9 mm removed 98.9% of melanoma in situs. The superiority of 9-mm to 6-mm margins was significant ( P Limitations Margins less than 6 mm were not studied. This is a referral center for melanoma in situ and 10% of tumors were previously treated before presentation to our clinic. Conclusion The frequently recommended 5-mm margin for melanoma is inadequate. Standard surgical excision of melanoma in situ should include 9 mm of normal-appearing skin, similar to that recommended for early invasive melanoma. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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