Association between excision margins and local recurrence in 1407 patients with primary in situ melanomas

Licata, Gaetano; Birra, Domenico; Lo, Serigne; Hamed, Tasnia; Potter, Alison; Thompson, John F.; Scolyer, Richard A.; Guitera, Pascale

doi:10.1016/j.jdin.2022.06.001

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…When patients present with primary or recurrent melanoma on the T&E, the goal of surgery is complete removal with histologically negative margins. The true local recurrence rate from inadequate excision of melanoma by WLE on the T&E is unknown because of poor definitions of local recurrence that include satellite metastases, short follow-up, and lack of data on location, [17][18][19][20][21] but the best estimate is that 2% of T&E melanomas recur at the margin. 22 In contrast, the 5-year true local recurrence after Mohs surgery for melanoma on the T&E is approximately 0.1%.…”

Section: Discussionmentioning

confidence: 99%

The Controversy and Value of Mohs Micrographic Surgery for Melanoma and Melanoma in Situ on the Trunk and Extremities

Zitelli,

Stiegel,

Brodland

2023

Dermatol Surg

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BACKGROUND The use of Mohs surgery for melanoma on the trunk and extremities is not supported in the guidelines of dermatology, but is widely used in the real world. OBJECTIVE The purpose of this article is to expose the value of Mohs surgery for melanoma on the trunk and extremities for consideration of updating the guidelines. MATERIALS AND METHODS This was a retrospective review of a prospectively maintained database 7 to identify patients whose melanomas would likely have recurred using standard surgical margins. A prediction model was used to evaluate the value of Mohs surgery. RESULTS The model predicted that 2,847 (2%) patients with melanoma on the trunk and extremities would likely recur each year with standard surgical margins even after re-excision when positive margins were identified, compared with 0.1% after Mohs surgery. This likely would result in the upstaging of 27% of melanoma in situ patients and 13% of patients with invasive melanoma. The upstaging would also result in a decrease in melanoma-specific survival and the death of 1% of patients with true local recurrences of melanoma. CONCLUSION Mohs surgery has value for melanoma on the trunk and extremities by minimizing local recurrence and death from disease progression.

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Section: Discussionmentioning

confidence: 99%

The Controversy and Value of Mohs Micrographic Surgery for Melanoma and Melanoma in Situ on the Trunk and Extremities

Zitelli,

Stiegel,

Brodland

2023

Dermatol Surg

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Amoeba‐Inspired Soft Robot for Integrated Tumor/Infection Therapy and Painless Postoperative Drainage

Zhou,

Xiong,

et al. 2024

Advanced Science

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Tumor recurrence and wound infection are devastating complications of wide excision surgery for melanoma, and deep postoperative wound drainage typically increases pain. An amoeba‐inspired magnetic soft robot (ASR) with switchable dormant and active phases is developed to address the aforementioned challenges. The dormant ASR supports wounds through its solid‐like elasticity and regulates reactive oxygen species (ROS) levels bidirectionally, promoting healing in infected wounds and eliminating residual tumors. It solves the challenge caused by the contradictory need for ROS scavenging in wound healing and ROS amplification in tumor/infection management. The active ASR removes absorbed wound exudate by crawling out from irregular wounds; interestingly, this crawling motion prevents damage to fragile tissues and alleviates wound pain via “non‐direct friction.” More importantly, ASR switches different states in response to an alternating magnetic field owing to its magnetothermal properties, and this process also exerts synergistic antitumor and bacteriostatic effects. Due to the appropriate mechanical structure (cohesive force) of ASR, the content of magnetic nanoparticles required to drive the ASR is ten‐fold lower than that of conventional magnetic soft robots, enabling in vivo degradation. These outcomes highlight the vantage of the ASR for treating post‐tumor excision wounds and underscore their potential for clinical application.

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Clinical updates in neoadjuvant immunotherapy for melanoma before surgery

Saad

Castellano

Tarhini

2023

Expert Review of Clinical Immunology

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Association between excision margins and local recurrence in 1407 patients with primary in situ melanomas

Cited by 3 publications

References 27 publications

The Controversy and Value of Mohs Micrographic Surgery for Melanoma and Melanoma in Situ on the Trunk and Extremities

The Controversy and Value of Mohs Micrographic Surgery for Melanoma and Melanoma in Situ on the Trunk and Extremities

Amoeba‐Inspired Soft Robot for Integrated Tumor/Infection Therapy and Painless Postoperative Drainage

Clinical updates in neoadjuvant immunotherapy for melanoma before surgery

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