Descriptive survival study of nail melanoma patients treated with functional surgery versus distal amputation

Montagner, Suelen; Belfort, Francisco Aparecido; Belda, Walter; Chiacchio, Nilton Di

doi:10.1016/j.jaad.2017.12.030

Cited by 14 publications

(17 citation statements)

References 5 publications

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“…found a significant correlation between concomitant trauma in NAM and lower survival rates. The level of resection was not shown to influence survival outcome in any of the studies …”

Section: Resultsmentioning

confidence: 81%

“…A non‐amputational surgical approach was chosen in 403 cases (30.0%). Seventeen studies reported performance of ‘en bloc’ wide local excision including the distal pulp of the digit, proximal and two lateral nail folds . Two studies reported ‘extended en bloc’ or ‘functional surgery’ excision through additional amputation of the most distal part of the distal phalanx …”

Section: Resultsmentioning

confidence: 99%

“…Applied lateral and proximal safety excision margins from the nail plate or clinically apparent lesion were inconsistent and ranged from 5 to 10 mm for both in situ and invasive melanomas or were indistinct with 3–5 mm or ‘wide’ or ‘generous’ . Deep margin resection included or excluded the periosteum.…”

Section: Resultsmentioning

confidence: 99%

“…In 700 cases (52.5%), amputation was the treatment of choice and consisted in the partial or full resection of one or more phalanges and/or metacarpal or metatarsal bones. Reported levels of amputation were (ranging from distal to proximal) the partial amputation of the distal phalanx, distal interphalangeal joint, median phalanx, proximal interphalangeal joint, metacarpo‐/metatarsophalangeal joint, metacarpal/metatarsal and carpometacarpal joint …”

Section: Resultsmentioning

confidence: 99%

“…Tumour thickness was reported in 29 studies. Mean Breslow values were available from 12 studies with unselected tumour thicknesses and ranged from 0.82 to 8.70 mm . Ulceration status was mentioned with rates between 8.3% and 70.8% in 13 studies .…”

Section: Resultsmentioning

confidence: 99%

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Melanoma of the nail apparatus: a systematic review and meta‐analysis of current challenges and prognosis

Lieberherr

Cazzaniga

Haneke

et al. 2020

Acad Dermatol Venereol

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Nail apparatus melanoma (NAM) is a rare dermatologic malignancy. Its prognosis is poor because it is often diagnosed late. However, progression and survival of NAM patients have only been studied among small populations. Early biopsy could help to identify suspicious lesions at a less invasive stage. While surgery is generally seen as the treatment of choice, the extent of excision margins and the use of sentinel biopsy remain debated. This systematic review aims to summarize the treatment procedures and observed prognosis in the literature during the last two decades and present pooled survival and progression rates of NAM by using meta-analysis. A systematic review on studies assessing pathology, treatment and prognosis of NAM was carried out up to end of 2018. After evaluation of eligible studies, the main emerging topics were outlined and pooled survival outcomes estimated. A total of 30 articles out of 624 identified records were included for systematic review. Finally, meta-analysis of pooled mortality rates including 18 studies was 4.6 9 100 patient-years (95% CI: 2.7, 6.8) equivalent to 5-year cumulative survival of 77.0%. Additionally, the pooled progression rate based on 17 studies was 6.3 9 100 patient-years (95% CI: 4.1, 8.9) with estimated 5-year cumulative progression-free survival of 68.5%. While the optimal extent of surgical treatment remains debated, prompt biopsy could help to identify early lesions. This is the first study to present pooled survival and progression rates by meta-analysis.

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“…found a significant correlation between concomitant trauma in NAM and lower survival rates. The level of resection was not shown to influence survival outcome in any of the studies …”

Section: Resultsmentioning

confidence: 81%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Melanoma of the nail apparatus: a systematic review and meta‐analysis of current challenges and prognosis

Lieberherr

Cazzaniga

Haneke

et al. 2020

Acad Dermatol Venereol

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Surgical excision methods for skin cancer involving the nail unit: A systematic review

Hardie,

Wade,

Wormald

et al. 2023

Cochrane Evidence Synthesis and Methods

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IntroductionSkin cancer affecting the nail unit is rare but is associated with morbidity, and melanoma has a high mortality rate. The principal treatment is surgical excision and methods can be classified into digit‐sparing surgery or amputation. Digit‐sparing surgery (wide excision or Mohs surgery) may be safe and effective for malignancies involving the nail unit in comparison to amputation if there is not bony invasion. The objective was to assess the efficacy and safety of different methods of surgical excision for skin cancer involving the nail unit.MethodsProspective comparative studies (randomized controlled studies, non‐randomized controlled studies and prospective observational studies) of surgical excision for skin cancer of the nail unit in all participants were eligible for inclusion. We searched electronic databases, trials registers and conference abstracts. We checked the reference lists of included studies and related systematic reviews for further references to relevant studies, and we contacted experts to enquire if they were aware of any additional relevant trials. We used standard methodological procedures expected by Cochrane. The primary outcomes were overall survival, disease free survival and adverse events/outcomes at 30 days. The secondary outcomes were quality of life outcomes. We planned to use GRADE to assess the quality of the evidence for each outcome.ResultsWe did not identify any studies that met the inclusion criteria for this review. We have been unable to assess our outcomes of overall survival, disease free survival, adverse events/effects and quality of life.ConclusionsAs we have not identified any studies for inclusion, we are unable to assess the efficacy and safety of different methods of surgical excision for skin cancer involving the nail unit. We suggest that comprehensive cancer registry analysis is required in this field to obtain meaningful data.

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Management of Nail Unit Melanoma

Zhang

Yun

McMurray

et al. 2021

Dermatologic Clinics

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Descriptive survival study of nail melanoma patients treated with functional surgery versus distal amputation

Cited by 14 publications

References 5 publications

Melanoma of the nail apparatus: a systematic review and meta‐analysis of current challenges and prognosis

Melanoma of the nail apparatus: a systematic review and meta‐analysis of current challenges and prognosis

Surgical excision methods for skin cancer involving the nail unit: A systematic review

Management of Nail Unit Melanoma

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