Surgical excision margins for primary cutaneous melanoma

Sladden, Michael J; Balch, Charles M.; Barzilai, David A.; Berg, Daniel J.; Freiman, Anatoli; Handiside, Teenah; Hollis, Sally; Lens, Marko; Thompson, John F.

doi:10.1590/s1516-31802011000100014

Cited by 16 publications

(16 citation statements)

References 2 publications

(1 reference statement)

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“…Based on the results of the controlled clinical studies conducted to date and on a recent meta-analysis, sufficiently WE margins should not be more than 2 cm [31]. …”

Section: Surgical Treatmentmentioning

confidence: 99%

Melanoma M (Zero): Diagnosis and Therapy

et al. 2013

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This paper reviews the epidemiology, diagnosis, and treatment of M zero cutaneous melanoma including the most recent developments. This review also examined the main risk factors for melanoma. Tumor thickness measured according to Breslow, mitotic rate, ulceration, and growth phase has the greatest predictive value for survival and metastasis. Wide excision of the primary tumor is the only potentially curative treatment for primary melanoma. The sentinel node biopsy must be performed on all patients who have a primary melanoma with a Breslow thickness > 1 mm, or if the melanoma is from 0,75 mm to 1 mm thick but it is ulcerated and/or the mitotic index is ≥1. Total lymph node dissection consists in removing the residual lymph nodes in patients with positive sentinel node biopsy, or found positive on needle aspiration biopsy, without radiological evidence of spread. Isolated limb perfusion and isolated limb infusion are employed in patients within transit metastases with a rate of complete remission in around 50% and 38% of cases. Electrochemotherapy is mainly indicated for palliation in cases of metastatic disease, though it may sometimes be useful to complete isolated limb perfusion. The only agent found to affect survival as an adjuvant treatment is interferon alpha-2. Adjuvant radiotherapy improves local control of melanoma in patients at a high risk of recurrence after lymph node dissection.

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“…Based on the results of the controlled clinical studies conducted to date and on a recent meta-analysis, sufficiently WE margins should not be more than 2 cm [31]. …”

Section: Surgical Treatmentmentioning

confidence: 99%

Melanoma M (Zero): Diagnosis and Therapy

et al. 2013

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“…While it accounts for only around 5% of all skin cancers, it is responsible for 75% of deaths among skin cancer patients. 1 …”

Section: Introductionmentioning

confidence: 99%

Association Between Race/Ethnicity and Survival of Melanoma Patients in the United States Over 3 Decades

et al. 2016

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Melanoma is a treatable and preventable skin cancer. It is responsible for 75% of deaths among all skin cancers. Previous studies have found that race/ethnicity may play a role in survival among melanoma patients. However, there are no studies that cover 30 years and take race into account for the U.S. population.This study is a secondary analysis of the National Cancer Institute's Surveillance, Epidemiology, and End Result (SEER) Program. Adults with primary cutaneous melanoma from 1982 to 2011 were included; the final sample size was 185,219. The outcome was survival; both cause-specific and all-cause mortality were examined. The main exposure was race/ethnicity. Kaplan–Meier survival analysis was used to estimate overall survival. Cox proportional hazards regression was used to estimate unadjusted and adjusted hazard ratios (HRs). A P-value less than 0.05 was considered statistically significant.More than 50% of patients in all races/ethnicities were diagnosed at the in situ or localized stage. Non-Hispanic White patients were more frequently diagnosed at the in situ stage. Overall, more men were diagnosed than women. The majority of cases among all races were men. Non-Hispanic Black females represented the smallest percentage of melanoma cases among all races. The smallest number of diagnoses across all races/ethnicities was made from 1982 to 1991. Median follow-up was 81 months and no collinearity was observed in the adjusted models. When examining cause-specific mortality and controlling for site and stage at diagnosis, gender, age and decade of diagnosis, the HR for non-Hispanic Black patients was lower than that for non-Hispanic White patients (HR 0.7; 95% confidence interval (CI): 0.6–0.8). However, when examining all-cause mortality, this difference disappeared (HR 1.1; 95% CI: 1.0–1.2). Stage at diagnosis impacted HR; patients diagnosed with distant metastases had significantly worse survival.When taking cause-specific mortality into consideration and after controlling for stage and site at diagnosis, gender, and age and decade of diagnosis, non-Hispanic Black patients had a lower HR compared to non-Hispanic White patients. However, this difference disappeared when examining all-cause mortality. Further research is needed to explore this finding and to determine what factors may be associated with late-stage melanoma diagnosis.

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“…These changes eliminate the need for grafts thereby greatly reducing hospital and recovery time. However they do not appear to improve the survival rate [1,2]. Diagnosis of all four types of melanoma at an early stage is the key to the best prognosis and to possibly preventing death.…”

Section: Introductionmentioning

confidence: 99%

The Connection between the Presence of Melanoma and Changes in Fibre Diffraction Patterns

James

Kirby

2010

Cancers

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An accurate diagnosis of melanomas at an early stage correlates directly with a better prognosis. However the incidence of melanoma is still increasing along with the number of related deaths. Melanoma cells grow extremely fast, with the result that many patients present after metastasis has occurred, too late for effective treatment. This paper describes the changes in the fibre diffraction patterns of skin that indicate the presence of a melanoma. Identification of these changes would provide an alternative early low-cost, reliable diagnostic test which could be conducted on a regular basis in local radiology facilities using rotating anode X-ray generators or as a mass screening test using suitable small angle x-ray beam-lines at synchrotrons.

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Surgical excision margins for primary cutaneous melanoma

Cited by 16 publications

References 2 publications

Melanoma M (Zero): Diagnosis and Therapy

Melanoma M (Zero): Diagnosis and Therapy

Association Between Race/Ethnicity and Survival of Melanoma Patients in the United States Over 3 Decades

The Connection between the Presence of Melanoma and Changes in Fibre Diffraction Patterns

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