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Patterns of failure following the excision of in‐transit lesions in melanoma and the influence of excisional margins
Author(s) -
Gonzalez Alexandra B.,
Baum Christian L.,
Brewer Jerry D.,
Arpey Christopher J.,
Harmsen William S.,
Suman Vera J.,
Markovic Svetomir N.,
Jakub James W.
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25176
Subject(s) - medicine , cumulative incidence , incidence (geometry) , lesion , surgery , retrospective cohort study , wide local excision , transplantation , physics , optics
Background and Objectives To describe the patterns of failure in patients with in‐transit (IT) melanoma undergoing surgical excision. Methods A retrospective review of patients who underwent their first IT lesion(s) resection between May 2005 and September 2014. Cumulative incidence of local failure (new lesion within 2 cm of IT resection) was estimated. Associations between clinicopathologic characteristics, local failure, and any recurrence were analyzed. Results One hundred and thirty patients presented to our institution with IT disease over the study period and met the inclusion criteria. The 2‐year cumulative incidence of local failure was 19.5%. Twenty‐four patients developed disease within 2 cm of the resected IT disease; however, only eight were isolated local events. Cumulative incidence of local failure and of any disease differed with respect to less than 1 year disease‐free interval (DFI) from primary melanoma to first IT event, and having greater than 1 IT lesion at presentation. Incidence of local failure was not found to differ with respect to gross margin greater than 5 mm, after adjusting for DFI and greater than 1 IT lesions. Conclusions Patients with greater than 1 IT lesion and a DFI less than 1 year are at a higher risk of failure after surgical excision of a first IT event. Very few failures were isolated local disease within 2 cm of the IT resection scar, regardless of IT excision margin.