Histological Peripheral Margins and Recurrence of Melanoma In Situ Treated with Wide Local Excision.
Histological Peripheral Margins and Recurrence of Melanoma In Situ Treated with Wide Local Excision.
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DOI：
10.1155/2020/8813050
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发表时间：
2020
影响因子：
1.1
通讯作者：
McKirdy SW
中科院分区：
文献类型：
--
作者：
Moura FS;Homer LE;McKirdy SW
原位黑色素瘤（MIS）的发病率与侵袭性黑色素瘤相比增长更快。尽管不同的国际惯例，最小的5毫米手术切除边缘目前在英国的建议。关于最小组织学外周清除率边缘没有明确的指导。 本研究比较了采用广泛局部切除术（WLE）的MIS的组织学外周清除边缘与复发率和进展为浸润性疾病的比率。 进行了为期5年的回顾性单中心审查。入选标准包括MIS诊断、年龄≥16岁和以治愈为目的的WLE治疗。还包括既往MIS复发或报告病灶浸润/消退的患者。记录临床病理资料并随访。 155例患者共检出MIS 167例，其中恶性雀斑样痣占80%。在组织学上完全切除MIS（>0 mm）的患者中，9%复发，中位复发时间为36个月。3例（1.8%）复发为浸润性疾病。年龄、MIS部位、MIS亚型和浸润/消退灶的组织学证据不能预测复发或进展为浸润性疾病（p > 0.05）。组织学切缘≤3.0 mm的MIS复发率为13%，而组织学切缘>3.0 mm的MIS复发率为3%（p=0.049）。 主张组织学外周间隙至少为3.0 mm，以降低复发率。由于我们队列中的中位复发发生在36个月，因此应审查随访持续时间。MIS的累积工作需要在一项随访期较长的大型多中心研究中进行整理和完成。
The incidence of melanoma in situ (MIS) is increasing faster compared to invasive melanoma. Despite varying international practice, a minimum of 5 mm surgical excision margin is currently recommended in the UK. There is no clear guidance on the minimum histological peripheral clearance margins. This study compares the histological peripheral clearance margins of MIS using wide local excision (WLE) to the rate of recurrence and progression to invasive disease. A retrospective single-center review was performed over a 5-year period. Inclusion criteria consisted of MIS diagnosis, ≥16 years of age, and treatment with WLE with curative intent. Those patients with a recurrence of a previous MIS or with a reported focus of invasion/regression were also included. Clinicopathological data and follow-up were recorded. 167 MIS were identified in 155 patients, 80% of which were lentigo maligna subtype. Of patients with completely excised MIS on histology (>0 mm), 9% had recurrence with a median time to recurrence of 36 months. Three (1.8%) cases recurred as invasive disease. Age, MIS site, MIS subtype, and histological evidence of foci of invasion/regression did not predict recurrence nor progression to invasive disease (p > 0.05). The recurrence rate of MIS with a histological excision margin ≤3.0 mm was 13% compared to 3% in those with histology margins of >3.0 mm (p=0.049). A histological peripheral clearance of at least 3.0 mm is advocated to achieve lower recurrence rates. The follow-up duration should be reviewed due to the median recurrence occurring at 36 months in our cohort. Cumulative work on MIS needs to be collated and completed in a large multicenter study with a long follow-up period.
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影响因子：
2.4
作者：
McKenna, JK;Florell, SR;Bowen, GM
通讯作者：
Bowen, GM
影响因子：
2.3
作者：
Coory, M;Baade, P;Ring, I
通讯作者：
Ring, I
影响因子：
2.4
作者：
Hou, Jennifer L.;Reed, Kurtis B.;Roenigk, Randall K.
通讯作者：
Roenigk, Randall K.
影响因子：
--
作者：
Huilgol, SC;Selva, D;Malhotra, R
通讯作者：
Malhotra, R
影响因子：
7.5
作者：
King, R;Page, RN;Mihm, MC
通讯作者：
Mihm, MC