Recurrence rate of lentigo maligna after micrographically controlled staged surgical excision3. (27th January 2016)

• Record Type: Journal Article
• Authors: de Vries, K.; Greveling, K.; Prens, L.M.; Munte, K.; Koljenović, S.; van Doorn, M.B.A.; Prens, E.P.
• Is Part Of: British journal of dermatology. Volume 174:Number 3(2016)
• Page Start: 588
• Page End: 593
• Publication Date: 2016-01-27
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.14325
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Background: Lentigo maligna is a slowly growing melanoma in situ . Current guidelines advise wide local excision with a margin of 5 mm as the treatment of first choice, which has recurrence rates ranging from 6% to 20%. Objectives: To determine retrospectively the recurrence rate of lentigo maligna after staged surgical excision. Methods: Records of all patients with lentigo maligna treated with our method of staged surgical excision between 2002 and 2011 were retrieved. To identify recurrences we used the computer program Sympathy, which is linked to PALGA, a nationwide network and registry of histo‐ and cytopathology in the Netherlands. Results: We identified 100 patients, who were treated with staged surgical excision with 100% immunohistopathological control of lateral margins. Digital pictures were used to facilitate orientation during the several stages of surgery. After a mean follow‐up of 60 months, four patients had a recurrence, after 37, 58, 74 and 77 months of follow‐up. Conclusions: Staged surgical excision is superior in clearance and recurrence rates to wide local excision for lentigo maligna and should be considered as the treatment of first choice in national and international guidelines. Abstract : What's already known about this topic? Current guidelines advise wide local excision as the treatment of first choice for lentigo maligna. What does this study add? We present a method of staged surgical excision that enables achievement of free margins and a low recurrence rate. Staged surgical excision is superior in clearance rate and recurrence rate compared with wide local excision and may therefore be considered as the treatment of first choice. Plain language summary available online