Mohs Micrographic Surgery for Invasive Melanoma Allows for Tissue Preservation Compared With Wide Local Excision: A Retrospective Cohort Study.

IF 2.5 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery Pub Date : 2024-11-01 Epub Date: 2024-06-18 DOI:10.1097/DSS.0000000000004270

Melissa M Rames, Elliott Campbell, Eucabeth Asamoah, Thomas Trischman, Anagha Bangalore Kumar, Nahid Y Vidal, Addison Demer

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引用次数: 0

Abstract

Background: While increasing evidence supports the safety and effectiveness of immunohistochemistry-assisted Mohs micrographic surgery (MMS) for superficially invasive melanoma, there is a paucity of the literature investigating its effect on final defect size.

Objective: To evaluate the tissue sparing effect of MMS for melanoma.

Materials and methods: Three hundred and twenty-eight patients with early-stage (T1a/T1b) cutaneous melanomas treated with MMS from January 2008 to December 2018 were evaluated. Measured defect sizes after Mohs tumor extirpation were compared with anticipated defect size that would result from standard-margin wide local excision (WLE). Average actual versus anticipated defect areas were compared using a paired t -test (95% confidence intervals).

Results: The following groups demonstrated a significantly smaller defect area for MMS-treated tumors when compared with anticipated standard-margin WLE defect: All tumors combined (13.8 cm 2 vs 10.4 cm 2 , p < .001), tumors requiring 1 stage (13.6 cm 2 vs 10.1 cm 2,p < .001), and tumors requiring 2 stages (13.2 cm 2 vs 10.5 cm 2 , p = .004). The majority of patients (83.5%, n = 274) achieved clear margins with 1 stage.

Conclusion: Immunohistochemistry-assisted MMS for early-stage invasive melanoma is associated with smaller final defect size and overall tissue sparing effect compared with standard WLE margins.

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莫氏显微外科手术治疗浸润性黑色素瘤与大范围局部切除术相比可保留组织：一项回顾性队列研究。

背景：虽然越来越多的证据支持免疫组化辅助莫氏显微外科手术（MMS）治疗浅表浸润性黑色素瘤的安全性和有效性，但研究其对最终缺损大小影响的文献却很少：目的：评估莫氏显微外科手术治疗黑色素瘤的组织疏通效果：对2008年1月至2018年12月期间接受MMS治疗的328例早期（T1a/T1b）皮肤黑色素瘤患者进行评估。将莫氏肿瘤切除术后测量的缺损大小与标准边缘宽局部切除术（WLE）的预期缺损大小进行比较。使用配对 t 检验（95% 置信区间）比较实际与预期缺损面积的平均值：结果：与预期的标准边缘宽局部切除术（WLE）缺损面积相比，以下几组经 MMS 治疗的肿瘤缺损面积明显较小：所有肿瘤（13.8 cm2 vs 10.4 cm2，p < .001）、需要分期的肿瘤（13.6 cm2 vs 10.1 cm2，p < .001）和需要分两期的肿瘤（13.2 cm2 vs 10.5 cm2，p = .004）。大多数患者（83.5%，n = 274）在分期时边缘清晰：结论：与标准WLE边缘相比，免疫组化辅助MMS治疗早期浸润性黑色素瘤的最终缺损面积更小，整体组织疏通效果更好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatologic Surgery 医学-皮肤病学

CiteScore

3.10

自引率

16.70%

发文量

547

期刊介绍： Exclusively devoted to dermatologic surgery, the Dermatologic Surgery journal publishes the most clinically comprehensive and up-to-date information in its field. This unique monthly journal provides today’s most expansive and in-depth coverage of cosmetic and reconstructive skin surgery and skin cancer through peer-reviewed original articles, extensive illustrations, case reports, ongoing features, literature reviews and correspondence. The journal provides information on the latest scientific information for all types of dermatologic surgery including: -Ambulatory phlebectomy- Blepharoplasty- Body contouring- Chemical peels- Cryosurgery- Curettage and desiccation- Dermabrasion- Excision and closure- Flap Surgery- Grafting- Hair restoration surgery- Injectable neuromodulators- Laser surgery- Liposuction- Microdermabrasion- Microlipoinjection- Micropigmentation- Mohs micrographic surgery- Nail surgery- Phlebology- Sclerotherapy- Skin cancer surgery- Skin resurfacing- Soft-tissue fillers. Dermatologists, dermatologic surgeons, plastic surgeons, oculoplastic surgeons and facial plastic surgeons consider this a must-read publication for anyone in the field.