Margin Involvement after the Excision of Melanoma In Situ: The Need for Complete En Face Examination of the Surgical Margins

Kimyai‐Asadi, Arash; Katz, Tracy M.; Goldberg, Leonard Harry; Ayala, Gabriel B.; Wang, Steven Q.; Vujevich, Justin; Jih, Ming H.

doi:10.1111/j.1524-4725.2007.33313.x

Cited by 27 publications

(40 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…20 Moreover, studies have demonstrated that bread-loaf cross sections of excised melanoma in situ specimens at 4mm intervals have only a 19% chance of detecting a positive margin and recommend the use of complete en face examination of the surgical margins. 21 …”

Section: Introductionmentioning

confidence: 99%

Mohs Micrographic Surgery Using MART-1 Immunostain in the Treatment of Invasive Melanoma and Melanoma In Situ

Valentín-Nogueras

Brodland

Zitelli

et al. 2016

Dermatologic Surgery

View full text Add to dashboard Cite

Background Mohs Micrographic Surgery (MMS) with melanoma antigen recognized by T cells (MART-1) immunostaining is an effective treatment for cutaneous melanoma. Objective Determine the efficacy of MMS with MART-1 immunostains in the management of invasive and in-situ melanoma. Methods and Materials A retrospective cohort study evaluated 2, 114 melanomas in 1,982 patients excised using MMS and MART-1 immunostains. Margins required for excision were calculated based on Breslow thickness, location and size. Survival and local recurrence rates were calculated and compared with those of historical controls. Results The mean follow-up was 3.73 years. Local recurrence was identified in 0.49 % (7/1,419) of primary melanomas. ~82% of melanomas were excised with ≤6mm margins. The surgical margin was significantly related to tumor location and size, but not to Breslow thickness. The five-year Kaplan-Meier local recurrence and disease-specific survival were 0.59 ± 0.30 and 98.53 ± 0.42, respectively. MMS with MART-1 immunostains achieved lower local recurrence rates, and equivalent or higher Kaplan-Meier survival rates when compared with conventional wide local excision. Conclusion MMS with MART-1 immunostain is an effective treatment for melanoma as evidenced by low local recurrence rates. It offers the advantage of more tissue conserving margins than those recommended for conventional excision.

show abstract

Section: Introductionmentioning

confidence: 99%

Mohs Micrographic Surgery Using MART-1 Immunostain in the Treatment of Invasive Melanoma and Melanoma In Situ

Valentín-Nogueras

Brodland

Zitelli

et al. 2016

Dermatologic Surgery

View full text Add to dashboard Cite

show abstract

“…Mohs micrographic surgery (MMS), offers an appealing answer to the margin question in LM 56 . As in non‐melanoma skin cancer, the Mohs technique potentially allows for excision of the smallest amount of tissue while confirming histologic clearance.…”

Section: Introductionmentioning

confidence: 99%

Treatment options in melanoma in situ: topical and radiation therapy, excision and Mohs surgery

Erickson

Miller

2010

Int J Dermatology

View full text Add to dashboard Cite

Topical imiquimod therapy appears to provide relatively low cure rates for MIS, and because some of these lesions contain an unrecognized invasive component, should be used with extreme caution to treat this disease. Radiation therapy may be a useful second-line therapy if surgery is contraindicated. Excisional surgery is an appropriate therapy for clinically well-defined MIS; however, margins larger than 5 mm may be required when treating larger or indistinct lesions. Finally, for clinically ill-defined LM arising on sun-damaged skin, especially in regions of aesthetic concern, some form of complete peripheral margin assessment - one of the various forms of Mohs surgery - may provide the highest cure rate and create the smallest surgical defect.

show abstract

“…( B ). 15 Therefore, the results regarding the rate of incomplete excision in the two studies can be underestimated, given that less than 37% of the margin was checked. However, even considering the true results found in these studies, when compared to the results shown for MMS (below), one can conclude that MMS presents an advantage as a method for margin control with reduction of the recurrence rate in these supposedly high-risk locations.…”

Section: Methodsmentioning

confidence: 92%

Indication guidelines for Mohs micrographic surgery in skin tumors

Cernea

Gontijo

Pimentel

et al. 2016

An. Bras. Dermatol.

View full text Add to dashboard Cite

Mohs micrographic surgery is a technique used to excise skin tumors based on comprehensive surgical mapping, in which the surgeon removes the tumor, followed by a complete histological evaluation of the tumor's margins. The correlation of the presence of a tumor in histological examinations and its precise location on the surgical map result in a complete removal of the tumor with maximum normal tissue preservation. The present article seeks to provide general practitioners and healthcare specialists with guidelines regarding recommendations for Mohs micrographic surgery to treat skin tumors, based on the most reliable evidence available in medical literature on the subject. This bibliographic review of scientific articles in this line of research was conducted based on data collected from MEDLINE/PubMed. The search strategy used in this study was based on structured questions in the Patient, Intervention, Control, and Outcome (PICO) format. MeSH terms were used as descriptors. The indications of this technique are related to recurrence, histology, size, definition of tumor margins, and location of tumors. These guidelines attempt to establish the indications of Mohs surgery for different types of skin tumors.

show abstract

Margin Involvement after the Excision of Melanoma In Situ: The Need for Complete En Face Examination of the Surgical Margins

Cited by 27 publications

References 16 publications

Mohs Micrographic Surgery Using MART-1 Immunostain in the Treatment of Invasive Melanoma and Melanoma In Situ

Mohs Micrographic Surgery Using MART-1 Immunostain in the Treatment of Invasive Melanoma and Melanoma In Situ

Treatment options in melanoma in situ: topical and radiation therapy, excision and Mohs surgery

Indication guidelines for Mohs micrographic surgery in skin tumors

Contact Info

Product

Resources

About