Desmoplastic melanoma - The step-child in the melanoma family?

Nabil Wasif, Richard J. Gray, Barbara A. Pockaj

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Background: and Objectives Desmoplastic melanoma (DM) is a rare variant of cutaneous melanoma. Our goal was to study the surgical management of DM, identify prognostic factors, and impact of treatment options. Methods Patients with DM (n=1,735) were identified from the Surveillance, Epidemiology, and End Results database (1988-2006). Results The median age of the study population was 69 years and overall survival (OS) at 5 years 65%. DM was more common in males (65%), most commonly found on the head and neck (51%), and had a mean thickness of 2.97 mm. Patients undergoing a wide local excision (WLE; ≥1 cm) had improved 5-year OS compared to a simple excision (<1 cm) or biopsy alone (67% vs. 60% vs. 45%, respectively, P < 0.001). Of 505 patients (29%) undergoing sentinel node biopsy (SLNB), only 14 (2.8%) were positive. Traditional prognostic factors such as Breslow thickness, nodal positivity, and ulceration did not predict survival. On multivariate analysis only adjuvant radiation therapy [HR 1.65 (95% CI 1.17-2.31)] and WLE correlated with survival [HR 0.47 (95% CI 0.32-0.69)]. Conclusions: Desmoplastic melanoma does not share traditional prognostic factors with the melanoma family. Surgical resection with wide margins is needed to optimize survival and routine SLNB may be unnecessary.

Original languageEnglish (US)
Pages (from-to)158-162
Number of pages5
JournalJournal of Surgical Oncology
Volume103
Issue number2
DOIs
StatePublished - Feb 1 2011

Keywords

  • desmoplastic melanoma
  • margins
  • sentinel node
  • surgery
  • survival

ASJC Scopus subject areas

  • Surgery
  • Oncology

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