Local recurrence and survival in acral lentiginous melanoma comparing 3D histology and conventional histology. (October 2014)

• Record Type: Journal Article
• Authors: Schulz, Claudia; Häfner, Hans‐Martin; Breuninger, Helmut; Leiter, Ulrike
• Is Part Of: Journal der Deutschen Dermatologischen Gesellschaft. Volume 12:Number 10(2014)
• Page Start: 881
• Page End: 889
• Publication Date: 2014-10
• Subjects: Skin -- Diseases -- Periodicals; Dermatology -- Periodicals; 616.5005
• DOI: 10.1111/ddg.12448
• Languages: German
• ISSNs: 1610-0379

Abstract

<abstract abstract-type="main"> <title>Summary</title> <sec id="ddg12448-sec-0010" sec-type="section"> <title>Background</title> <p>Surgical treatment of acral lentiginous melanomas with wide excisional margins as recommended often requires amputation of distal extremities. The current study analyzes whether smaller excisions in combination with a complete histological evaluation of the excisional margins (3D histology) have a negative impact on the prognosis.</p> </sec> <sec id="ddg12448-sec-0020" sec-type="section"> <title>Patients and methods</title> <p>304 patients were retrospectively evaluated. 192 patients with reduced excisional margins followed by 3D histology (group A) were compared with 112 patients treated with conventional wide margins (group B). The outcome of both groups was compared.</p> </sec> <sec id="ddg12448-sec-0030" sec-type="section"> <title>Results</title> <p>The median tumor thickness was higher in group A (p = 0.022) and ulcerations occured more frequently (p = 0.017). The median excisional margin was 8 mm in group A and 20 mm in group B (p < 0.0001). 10.9 % (4.2 % invasive) of group A und 8.9 % (4.5 % invasive) of group B (p = 0.577) developed a local recurrence in a median of 40 months. The melanoma specific 10‐year survival was 66.8 % in group A und 63.4 % in group B (p = 0.531). There was no difference in survival of patients with or without local recurrence (p = 0.643).</p> </sec> <sec id="ddg12448-sec-0040" sec-type="section"> <title>Conclusions</title> <p>Excision with small margins followed by 3D histology is not inferior to conventional surgery with wide margins in terms of the rate of local and has no negative impact on prognosis or the further course of the disease. Local recurrences are rare and do not influence patient survival.</p> </sec> </abstract>