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A meta‐analysis on the influence of partial biopsy of primary melanoma on disease recurrence and patient survival
Author(s) -
Moscarella E.,
Pampena R.,
Palmiotti G.,
Bonamonte D.,
Brancaccio G.,
Piccolo V.,
Longo C.,
Argenziano G.
Publication year - 2020
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.15903
Subject(s) - medicine , biopsy , melanoma , retrospective cohort study , survival analysis , surgery , meta analysis , relative risk , cohort study , cohort , radiology , confidence interval , cancer research
Abstract Background Complete surgical excision is the preferred biopsy type for suspicious melanocytic lesions. However, partial biopsy is sometimes used in special situations. Previous studies have explored the effect of partial biopsy of a primary melanoma on patient outcome with controversial results. Objective We performed a meta‐analysis on the influence of the type of biopsy of a primary melanoma on recurrence‐free survival ( RFS ) and melanoma‐related survival ( MRS ). Methods Clinical trials, observational cohort studies and case–control studies reporting absolute number of recurrences and/or melanoma‐related deaths in patients undergoing a partial or excisional biopsy of melanoma were included in the meta‐analysis. Results In all, the five included studies reported 3249 patients, 1121 (34.5%) of them in the partial biopsy group and 2128 (65.5%) in the excisional biopsy group. Despite a trend in favour of excisional biopsy in reducing the risk for recurrences, the forest plot related to RFS failed to demonstrate significant differences among groups ( RR : 1.27; 95% CI 0.97–1.67; P : 0.09; random effects; I 2 : 55%). The forest plot showed no difference in the risk of dying for melanoma‐related causes for patients undergoing partial biopsy vs. excisions biopsy ( RR : 1.50; 95% CI 0.98–2.30; P : 0.06; random effects; I 2 : 60%). Limitations The majority of the studies were retrospective, and follow‐up time was not uniform among studies and not always reported. Conclusion In conclusion, a partial biopsy can be performed in special situations, such as large primary tumours located in surgically sensitive areas, without altering MRS and RFS .