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Conservative surgical management of superficially invasive cutaneous melanoma
Author(s) -
Benedict Cosimi A.,
Sober Arthur J.,
Mihm Martin C.,
Fitzpatrick Thomas B.
Publication year - 1984
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19840315)53:6<1256::aid-cncr2820530607>3.0.co;2-6
Subject(s) - medicine , melanoma , surgery , lymph node , conservative management , primary tumor , skin grafting , wide local excision , cancer , metastasis , pathology , cancer research
Between 1976 and 1980, 136 patients were evaluated for primary treatment of cutaneous melanoma. Forty‐nine lesions were invasive to Clark's Level II (38 patients) or III (II patients) with a thickness of 0.3 to 1.2 mm. Conservative re‐excision was advised as definitive therapy for these patients. The margin of resection was defined as the maximum excision that would allow primary closure of the wound. Pathology reports of the re‐excised specimens revealed the narrowest margins to be 0.7 to 4 cm. Unexpected residual tumor was present in 2 specimens and melanocytic hyperplasia in 12 specimens. After a follow‐up period of 2.5 to 7.0 years, there have been no local recurrences. One patient developed regional lymph node metastases 16 months and, then central nervous system (CNS) metastases 25 months after primary treatment. A second patient died with pulmonary metastases 4.5 years after initial therapy. Melanomas that are not deeply invasive do not require wide excision and skin grafting for local control. Occasionally these thin lesions do produce systemic metastases, emphasizing the need for long‐term follow‐up of even “low‐risk” patients. Cancer 53:1256–1259, 1984. Cancer 53:1256‐1259, 1984.