In response to Coronavirus Disease 2019, surgeons modified postoperative protocols to limit patient exposure. Our data demonstrates that, adult spinal deformity patients who underwent surgery during the pandemic had shorter hospital stays and higher rates of home discharge compared with before the pandemic, without any changes in complication or readmission rates.
Objectives/Hypothesis The objective of this study was to examine the difference between a narrow (between 1 and 2 cm) and a wide (>2 cm) margin in the surgical resection of head and neck cutaneous melanoma. Study Design Population‐based cohort analysis. Methods The Surveillance, Epidemiology, and End Results database was employed to identify patients who had cutaneous melanoma of the head and neck from 2004 to 2014. Outcome measures were overall survival (OS) and disease‐specific survival (DSS). Results Among the total of 3,583 cases of cutaneous melanoma of the head and neck with known resection margins, 2,641 individuals had narrow resection margins, and 942 patients had wide margins. Most of the tumors presented in the skin of the scalp and neck, followed by the face, external ear, and other areas. The 5‐year and 10‐year Kaplan‐Meier OS probabilities for narrow and wide margins were 65% and 66%, respectively, compared with 49% and 48%, respectively. The DSS probabilities exhibited similar trends between the two groups at these time points. In the Cox regression model, the patients who received narrow margins had similar OS (95% confidence interval [CI]: 0.918‐1.217) and DSS (95% CI: 0.856‐1.352) compared with the wide resection margin group, even when controlled for age, sex, T stage, and histology. Conclusions The survival of patients with cutaneous melanoma of the head and neck depends on age, depth of tumor invasion, and histology. Within the head and neck, a wider resection margin of >2 cm does not confer any additional survival benefit compared with a narrower margin. Future studies should examine whether wider surgical margins would confer survival benefit in local or recurrent melanoma. Level of Evidence 4 Laryngoscope, 129:1386–1394, 2019
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