Can we reduce excision margins for head and neck melanoma? A 12-year retrospective study
| Autor: | Rishi Pandya, Merendeep Basra, Kieron McVeigh, Eoin Twohig |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Surgical margin medicine.medical_treatment Esthetics Dental 03 medical and health sciences Excision margins 0302 clinical medicine Medicine Humans 030212 general & internal medicine Prospective Studies Stage (cooking) Head and neck Melanoma Retrospective Studies business.industry Wide local excision Standard treatment Margins of Excision Retrospective cohort study medicine.disease Surgery Otorhinolaryngology 030220 oncology & carcinogenesis Oral Surgery business |
| Zdroj: | The British journal of oralmaxillofacial surgery. 60(2) |
| ISSN: | 1532-1940 |
| Popis: | Although wide local excision is the standard treatment for primary melanomas, the surgical margin remains controversial. Melanomas of the head and neck exhibit higher recurrence rates and worse prognosis than lesions in other body locations and they are in close proximity to critical anatomical and functional structures where wide margins of excision are often not feasible. Surgeons must achieve a balance of oncological safety and functional and aesthetic needs. The aim of this study was to retrospectively analyse melanoma data over a 12 year period at a large skin surgery unit and identify potential differences in outcomes in those patients who had reduced wide local excision margin for primary head and neck melanoma. This study would provide further evidence for the need for large randomised prospective trials to reduce excision margins for head and neck melanoma. Local cancer network data was retrospectively analysed over a period of twelve years (2008-2019). Data analysed included site, initial stage, multidisciplinary team meeting recommendations for excision margin, actual wide local excision margin taken, recurrence rate, disease specific and absolute survival. 73% (222/305) of patients had recommended excision margins, with 27% of melanomas undergoing reduced margins due to anatomical or functional considerations. The recurrence rates are similar in recommended (11.7%) vs narrow (13.3%) excision margins (p = 0.64). Mean follow up time for all patients was 48.5 months. In aesthetically and functionally sensitive areas of the head and neck, the WLE margins need to be carefully considered after MDT discussion and with the patient. This study suggests the need for further multi-centre trials to address the uniqueness of head and neck melanoma. |
| Databáze: | OpenAIRE |
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