Performance of the 'if in doubt, cut it out' rule for the management of nodular melanoma
| Autor: | Aimilios Lallas, Alessio Gambardella, Roberto Alfano, Iris Zalaudek, Amalia Lupoli, Giuseppe Argenziano, Caterina Longo, Stefano Caccavale, Elvira Moscarella |
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| Přispěvatelé: | Moscarella, Elvira, Lallas, Aimilio, Longo, Caterina, Zalaudek, Iri, Caccavale, Stefano, Gambardella, Alessio, Lupoli, Amalia, Alfano, Roberto, Argenziano, Giuseppe |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
dermatoscopy nodular melanoma number needed to excise skin cancer Dermatology Malignancy Nodular melanoma Benign tumor 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Genetics medicine Amelanotic melanoma neoplasms Molecular Biology Dermatoscopy medicine.diagnostic_test business.industry Melanoma Articles medicine.disease Superficial spreading melanoma Surgery Oncology 030220 oncology & carcinogenesis Radiology Skin cancer business |
| Zdroj: | Dermatology Practical & Conceptual |
| Popis: | Background The recognition of nodular melanoma is clinically challenging, and the diagnostic accuracy of dermoscopy and confocal microscopy is lower than for superficial spreading melanoma. Objectives To test a management strategy consisting in the excision of any nodular lesion that cannot be confidently and precisely classified as a benign tumor after clinical and dermoscopic examination. Methods Clinical and dermoscopic images of excised nodular lesions were retrospectively collected and evaluated. The evaluators were asked to record the level of diagnostic confidence for each lesion, by declaring if they were confident or doubtful about the given diagnosis. The NNE (number needed to excise) value was used to evaluate the efficacy of the proposed method. Results A total of 1,319 excised nodular lesions formed the study set. The NNE for any malignancy was 3.9 (634/164), while the NNE for melanoma was 13.2 (634/48). NNE for hypo and amelanotic melanoma was 27.3 (327/12). Conclusions Excising doubtful nodular lesions seems to be an effective management strategy not to miss nodular melanoma, resulting in an acceptable rate of unnecessary excision of benign lesions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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