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The Role of Wide Excision of Primary Lesion in Cutaneous Malignant Melanoma: A Retrospective Analysis on Its Usefulness in Local and General Control of Disease
Nacchiero, E.; Giotta, M.; Robusto, F.; Metta, M.E.; Ronghi, V.; Elia, R.; Trerotoli, P.; Maruccia, M.; Giudice, G. The Role of Wide Local Excision of a Primary Lesion in Cutaneous Malignant Melanoma: A Retrospective Analysis of Its Usefulness in Local and General Control of Disease. Melanoma Research 2024, doi:10.1097/cmr.0000000000000999.
Nacchiero, E.; Giotta, M.; Robusto, F.; Metta, M.E.; Ronghi, V.; Elia, R.; Trerotoli, P.; Maruccia, M.; Giudice, G. The Role of Wide Local Excision of a Primary Lesion in Cutaneous Malignant Melanoma: A Retrospective Analysis of Its Usefulness in Local and General Control of Disease. Melanoma Research 2024, doi:10.1097/cmr.0000000000000999.
Nacchiero, E.; Giotta, M.; Robusto, F.; Metta, M.E.; Ronghi, V.; Elia, R.; Trerotoli, P.; Maruccia, M.; Giudice, G. The Role of Wide Local Excision of a Primary Lesion in Cutaneous Malignant Melanoma: A Retrospective Analysis of Its Usefulness in Local and General Control of Disease. Melanoma Research 2024, doi:10.1097/cmr.0000000000000999.
Nacchiero, E.; Giotta, M.; Robusto, F.; Metta, M.E.; Ronghi, V.; Elia, R.; Trerotoli, P.; Maruccia, M.; Giudice, G. The Role of Wide Local Excision of a Primary Lesion in Cutaneous Malignant Melanoma: A Retrospective Analysis of Its Usefulness in Local and General Control of Disease. Melanoma Research 2024, doi:10.1097/cmr.0000000000000999.
Abstract
Actually wide excision is recommended after the primary excision of any cutaneous melanomas. The definition of the margins of wide excision indicated by the guidelines has remained unchanged over the years, although the reported indications derived from fairly dated studies, in which melanomas tend to be thicker or in advanced stages at diagnosis. These indications may no longer be current; especially in those patients affected by in situ or thin melanoma, exposing patients to a possible overtreatment. A retrospective observational study was conducted in patients who had undergone surgery for melanoma in a single institution. In a univariate model a melanoma-positive wide excision resulted related with a worst progression free survival (PFS); but this association was not confirmed in the multivariable model. Moreover, logistic model were applied to estimate the probability to find a metastasis after wide local excision (WLE) in relation to demographic data of patients and histologic information of the melanoma. Results testified that the Breslow thickness was the only factor associated with the increase of the risk to found metastases in the WLE area. The ROC curve testified that the optimum cut-off value to differentiate patients with respect those without a tumor-positive wide excision, was a Breslow thickness of 2.31mm in women, and 2.4mm in men.
Keywords
Wide excision; malignant melanoma; control of disease; overtreatment; melanoma prognosis
Subject
Medicine and Pharmacology, Surgery
Copyright:
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