Long term results of a randomized study by the Swedish Melanoma Study Group on 2-cm versus 5-cm resection margins for patients with cutaneous melanoma with a tumor thickness of 0.8-2.0 mm
| Autor: | Gabriella Cohn-Cedermark, Lars Erik Rutqvist, B A Hemming Johansson, Per-Ebbe Jönsson, Mats Breivald, Ulrik Ringborg, Lennart Krysander, Christian Ingvar, Christer Lindholm, Ronny Andersson |
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| Rok vydání: | 2000 |
| Předmět: |
Adult
Male Cancer Research Surgical margin medicine.medical_specialty Neoplasm Residual Skin Neoplasms Adolescent Resection law.invention Randomized controlled trial law medicine Humans Neoplasm Invasiveness In patient Melanoma Aged Aged 80 and over business.industry Follow up studies Long term results Middle Aged medicine.disease Survival Analysis Surgery Oncology Cutaneous melanoma Female Neoplasm Recurrence Local business |
| Zdroj: | Cancer. 89:1495-1501 |
| ISSN: | 1097-0142 0008-543X |
| DOI: | 10.1002/1097-0142(20001001)89:7<1495::aid-cncr12>3.0.co;2-d |
| Popis: | Large, prospective, randomized trials with long term follow-up are required to obtain an unbiased evaluation of the significance of resection margins in patients with cutaneous melanoma.The Swedish Melanoma Study Group performed a prospective, randomized, multicenter study of patients with primary melanoma located on trunk or extremities and with a tumor thickness0.8 mm and/= 2 mm. Patients were allocated randomly to a 2-cm excision margin or a 5-cm excision margin. In total, 989 patients were recruited during the period 1982-1991. The median follow-up was 11 years (range, 7-17 years) for estimation of survival and 8 years (range, 0-17 years) for evaluation of recurrent disease.The crude rate of local recurrence, defined as a recurrence in the scar or transplant, was1% (8 of 989 patients). Twenty percent of the patients (194 of 989 patients) experienced any disease recurrence, and 15% (146 of 989 patients) died of melanoma. There were no statistically significant differences between the two treatment arms. In a multivariate Cox analysis with patients allocated to wide excision as the reference group, the estimated relative hazards for overall survival and recurrence free survival among those allocated to a 2-cm resection margin were 0.96 (95% confidence interval, 0.75-1.24), and 1.02 (95% confidence interval, 0.80-1.30), respectively.In this long term follow-up study, local recurrences were found to be rare among patients with tumors0.8 mm thick and/= 2.0 mm thick. No difference in recurrence rate or survival between the two treatment groups was found. Patients in this category can be treated with a resection margin of 2 cm as safely as with a resection margin of 5 cm. |
| Databáze: | OpenAIRE |
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