Staged excision for lentigo maligna and lentigo maligna melanoma: A retrospective analysis of 117 cases

Hazan, Carole; Dusza, Stephen W.; Delgado, Ruby; Busam, Klaus J.; Halpern, Allan C.; Nehal, Kishwer S.

doi:10.1016/j.jaad.2007.09.023

Cited by 146 publications

(141 citation statements)

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“…Various techniques to achieve complete histologic margin control have been described including, but not limited to permanent section total peripheral margin control and Mohs micrographic surgery. 49,50,[104][105][106] No prospective randomized data are available to make specific recommendations. However, referral for more exhaustive histologic margin assessment may be considered when extensive subclinical extension is suspected.…”

Section: Surgical Managementmentioning

confidence: 99%

Guidelines of care for the management of primary cutaneous melanoma

Bichakjian

Halpern

Johnson

et al. 2011

Journal of the American Academy of Dermatology

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415

269

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Section: Surgical Managementmentioning

confidence: 99%

Guidelines of care for the management of primary cutaneous melanoma

Bichakjian

Halpern

Johnson

et al. 2011

Journal of the American Academy of Dermatology

Self Cite

415

269

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“…Therefore, it is not surprising that the head and neck region is the location of emergence [12]. Although they show slow growth, the treatment of choice is surgical excision [13, 14]. …”

Section: Introductionmentioning

confidence: 99%

A Retrospective Cohort Study on Patients with Lentigo Maligna Melanoma

et al. 2019

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Background: More epidemiological data about lentigo maligna melanoma (LMM) are required to define follow-up guidelines. The study focused on recurrence, progression, and overall survival of LMM managed with primary wide local excision. Methods: In a 23-year retrospective study (1994 to 2016), a cohort of patients with LMM was evaluated by collecting data about the tumor location, the Breslow depth, the presence of ulceration, and patients’ age and sex. Local recurrences, locoregional and distant metastases, and disease-free and overall survival were additionally assessed. Results: Overall, 150 cases (84 male, 66 female, mean age 71.3 ± 11.3 years) of single, localized, primary LMM with a mean follow-up of 6.6 ± 4.4 years were included. A total of 33 (22.2%) patients underwent sentinel lymph node biopsy (SLNB) during surgical excision. However, positive SLNB was detected in none of them. The multivariable Cox analysis indicated that age of diagnosis and male gender significantly influenced the overall survival, while a shorter disease-free survival could be correlated with a greater Breslow thickness. The metastatic potential turned out to be low, entailing 7 deaths in the context of the LMM. Conclusion: Male gender, age over 70 at diagnosis, and a Breslow thickness greater than 0.75 mm were associated with a statistically significant decrease in overall disease-free survival in the current study. The results of the study confirm the favorable outcome of LMM. However, diagnosed patients should undertake regular follow-ups. The intensity of follow-up in these patients can be individualized based on the probability of recurrence/metastasis and overall survival. Furthermore, the study showed that SLNB might not be a necessary staging procedure in patients with LMM.

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“…[3][4][5] Mohs micrographic surgery allows for better pathologic clearance compared to excision, with a 98.2% cure rate. 5,6 However, factors such as resectability, age, patient preference, and potential disfigurement can preclude surgical resections of LM. Nonsurgical options, such as cryotherapy, radiation, laser, and curettage, can be effective but may result in higher risks of scarring, long-term recurrence, or secondary skin cancers.…”

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confidence: 99%