Outcomes of Staged Excision With Circumferential en Face Margin Control for Lentigo Maligna of the Head and Neck
| Autor: | Jessica Kitchen, Annie Liu, Nowell Solish, An-Wen Chan, Christian Murray, Alexis A. Botkin |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Skin Neoplasms Dermatologic Surgical Procedures Dermatology Lentigo maligna Hutchinson's Melanotic Freckle 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Margin (machine learning) medicine Humans Surgical Wound Infection Head and neck Aged Neoplasm Staging Retrospective Studies Scalp business.industry Margins of Excision Middle Aged medicine.disease Circumferential margin Treatment Outcome 030220 oncology & carcinogenesis Female Surgery Radiology Facial Neoplasms Neoplasm Recurrence Local business Neck Follow-Up Studies |
| Zdroj: | Journal of Cutaneous Medicine and Surgery. 25:18-24 |
| ISSN: | 1615-7109 1203-4754 |
| DOI: | 10.1177/1203475420952425 |
| Popis: | Background Treatment practices vary for lentigo maligna (LM). Staged excision with circumferential margin control (SECMC) has the potential to achieve low recurrence rates. Objectives To evaluate the clinical outcomes of SECMC using permanent, paraffin-embedded sections and delayed reconstruction. Methods We conducted a retrospective, uncontrolled, observational cohort study involving patients who underwent staged excision for LM of the head and neck at Women’s College Hospital in Toronto, Canada, from September 2010 to March 2013. Recurrence and infection rates were ascertained from patient charts and postal surveys. Results One hundred and two patients (45 female, 57 male) were included with a median follow-up time of 1410.5 (IQR 260-1756) days. The median age was 69 (IQR 61-79) years. Approximately one-fifth (21%, 21/102) of patients required greater than 0.5 cm margins to achieve histological clearance. One patient (1/102) upstaged to invasive melanoma based on the initial stage of excision. The infection rate was 6% (6/102) and the 5-year cumulative recurrence rate was 1.4% (95% CI 0.2-9.6%). Conclusion SECMC using permanent sections and delayed reconstruction appears to be a safe and effective treatment method for LM on the head and neck. Randomized trials are needed to help define the optimal treatment. |
| Databáze: | OpenAIRE |
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