Risk factors predicting positive margins at primary wide local excision of cutaneous melanoma

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

BACKGROUND A small percentage of patients will have positive histological margins after primary wide local excision (WLE) of cutaneous melanoma (CM). Risk factors that predict marginal involvement at WLE remain unclear. OBJECTIVE To identify risk factors associated with positive margins after WLE of CM. MATERIALS AND METHODS A retrospective review of patients treated at a single institution for CM with sentinel lymph node biopsy from 1997 to 2011 was conducted. RESULTS Positive margins occurred in 6% of patients. Patients with positive margins were older (72.4 vs 60.7, p <.001), had thicker tumors (3.6 vs 1.9 mm, p <.001), and often involved the head and neck region (p <.001). Patients with positive margins at WLE had positive margins on initial biopsy (p .012) and a higher rate of a melanoma in situ component on initial biopsy (24% vs 11%, p .02). The 5-year local recurrence rate was significantly different between those with positive and negative margins at WLE (16.0% vs 6.9%; p .047). CONCLUSION Positive margins after WLE are uncommon. When a patient has multiple risk factors for positive margins at WLE, histologically clear margins should be obtained through mapped serial excision or Mohs micrographic surgery.

Original languageEnglish (US)
Pages (from-to)646-652
Number of pages7
JournalDermatologic Surgery
Volume42
Issue number5
DOIs
StatePublished - May 1 2016

Fingerprint

Melanoma
Skin
Mohs Surgery
Biopsy
Sentinel Lymph Node Biopsy
Neck
Head
Recurrence
Neoplasms

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)
  • Dermatology

Cite this

@article{7df9aa49b9b24b0a8e0081a8ec4b7c5b,
title = "Risk factors predicting positive margins at primary wide local excision of cutaneous melanoma",
abstract = "BACKGROUND A small percentage of patients will have positive histological margins after primary wide local excision (WLE) of cutaneous melanoma (CM). Risk factors that predict marginal involvement at WLE remain unclear. OBJECTIVE To identify risk factors associated with positive margins after WLE of CM. MATERIALS AND METHODS A retrospective review of patients treated at a single institution for CM with sentinel lymph node biopsy from 1997 to 2011 was conducted. RESULTS Positive margins occurred in 6{\%} of patients. Patients with positive margins were older (72.4 vs 60.7, p <.001), had thicker tumors (3.6 vs 1.9 mm, p <.001), and often involved the head and neck region (p <.001). Patients with positive margins at WLE had positive margins on initial biopsy (p .012) and a higher rate of a melanoma in situ component on initial biopsy (24{\%} vs 11{\%}, p .02). The 5-year local recurrence rate was significantly different between those with positive and negative margins at WLE (16.0{\%} vs 6.9{\%}; p .047). CONCLUSION Positive margins after WLE are uncommon. When a patient has multiple risk factors for positive margins at WLE, histologically clear margins should be obtained through mapped serial excision or Mohs micrographic surgery.",
author = "Aaron Mangold and Ryan Skinner and Amylou Dueck and Sekulic, {Aleksandar D} and Pockaj, {Barbara A}",
year = "2016",
month = "5",
day = "1",
doi = "10.1097/DSS.0000000000000702",
language = "English (US)",
volume = "42",
pages = "646--652",
journal = "Dermatologic Surgery",
issn = "1076-0512",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Risk factors predicting positive margins at primary wide local excision of cutaneous melanoma

AU - Mangold, Aaron

AU - Skinner, Ryan

AU - Dueck, Amylou

AU - Sekulic, Aleksandar D

AU - Pockaj, Barbara A

PY - 2016/5/1

Y1 - 2016/5/1

N2 - BACKGROUND A small percentage of patients will have positive histological margins after primary wide local excision (WLE) of cutaneous melanoma (CM). Risk factors that predict marginal involvement at WLE remain unclear. OBJECTIVE To identify risk factors associated with positive margins after WLE of CM. MATERIALS AND METHODS A retrospective review of patients treated at a single institution for CM with sentinel lymph node biopsy from 1997 to 2011 was conducted. RESULTS Positive margins occurred in 6% of patients. Patients with positive margins were older (72.4 vs 60.7, p <.001), had thicker tumors (3.6 vs 1.9 mm, p <.001), and often involved the head and neck region (p <.001). Patients with positive margins at WLE had positive margins on initial biopsy (p .012) and a higher rate of a melanoma in situ component on initial biopsy (24% vs 11%, p .02). The 5-year local recurrence rate was significantly different between those with positive and negative margins at WLE (16.0% vs 6.9%; p .047). CONCLUSION Positive margins after WLE are uncommon. When a patient has multiple risk factors for positive margins at WLE, histologically clear margins should be obtained through mapped serial excision or Mohs micrographic surgery.

AB - BACKGROUND A small percentage of patients will have positive histological margins after primary wide local excision (WLE) of cutaneous melanoma (CM). Risk factors that predict marginal involvement at WLE remain unclear. OBJECTIVE To identify risk factors associated with positive margins after WLE of CM. MATERIALS AND METHODS A retrospective review of patients treated at a single institution for CM with sentinel lymph node biopsy from 1997 to 2011 was conducted. RESULTS Positive margins occurred in 6% of patients. Patients with positive margins were older (72.4 vs 60.7, p <.001), had thicker tumors (3.6 vs 1.9 mm, p <.001), and often involved the head and neck region (p <.001). Patients with positive margins at WLE had positive margins on initial biopsy (p .012) and a higher rate of a melanoma in situ component on initial biopsy (24% vs 11%, p .02). The 5-year local recurrence rate was significantly different between those with positive and negative margins at WLE (16.0% vs 6.9%; p .047). CONCLUSION Positive margins after WLE are uncommon. When a patient has multiple risk factors for positive margins at WLE, histologically clear margins should be obtained through mapped serial excision or Mohs micrographic surgery.

UR - http://www.scopus.com/inward/record.url?scp=84978790756&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84978790756&partnerID=8YFLogxK

U2 - 10.1097/DSS.0000000000000702

DO - 10.1097/DSS.0000000000000702

M3 - Article

C2 - 27082057

AN - SCOPUS:84978790756

VL - 42

SP - 646

EP - 652

JO - Dermatologic Surgery

JF - Dermatologic Surgery

SN - 1076-0512

IS - 5

ER -