Effect of Biopsy Technique on the Survival Rate of Malignant Melanoma Patients

Abstract

BackgroundCutaneous malignant melanoma has a poor prognosis. The detrimental effect of incisional biopsies on the outcome of malignant melanoma has been debated. The aim of this study was to determine the effect of the presence and type of biopsy on the prognosis of malignant melanoma.MethodsThe medical records of 109 malignant melanoma patients treated at Tokushima University Hospital from 1983 to 2007 were reviewed. After excluding 28 cases with stage 0 disease or incomplete data, 81 cases were analyzed in detail with respect to patient sex, age, tumor site, clinical stage at diagnosis, presence of ulceration or lymph node metastasis, and prognosis. The five-year survival and five-year disease-free survival rates of patients who underwent incisional or excisional biopsies were compared with those who did not undergo a biopsy.ResultsThe male-to-female ratio was 1:1.19. The mean age was 61.3 years (range, 19-93 years). The most common site was a lower extremity, and the most common clinical stage was stage II. No significant differences in clinicopathological features, five-year survival rates, and five-year disease-free survival rates were observed among the three groups.ConclusionsThe presence and type of biopsy neither affected the metastatic rate nor the prognosis of malignant melanoma. The use of incisional biopsies is not encouraged because tumor thickness cannot be measured accurately. However, they may be helpful for confirming the diagnosis if an excisional biopsy cannot be performed.

A meta‐analysis on the influence of partial biopsy of primary melanoma on disease recurrence and patient survival

“…The number of patients included in each of these groups according to the biopsy type was not reported, but the author found that Breslow's thickness significantly influenced both disease-free and overall survival in multivariate Cox's regression analysis. Lederman et al 13 Austin et al 10 Bong et al 7 Martin et al 11 Yamashita et al 21 (27.9%) in the partial vs. excisional biopsy groups, respectively; Table 2]. 8,12 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.…”

“…1. Based on the abstracts, 10 studies [6][7][8][9][10][11][12][13][14]21 were selected for full-text examination. Of these, five were finally included in the systematic review because reporting information on RFS and/or MRS.…”

“…Cox's proportional hazard model for survival analysis showed that the biopsy type had no significant effect on recurrence or melanoma-related death. 11 Yamashita et al 21 in 2014 retrospectively analysed a database of 81 patients with melanoma, concluding that the type of biopsy did not significantly affect the 5-year survival rate (P = 0.659) and the 5-year disease-free survival rate (P = 0.153). 11 Differences were analysed among lesions undergoing complete surgical excision, incisional biopsy and shave biopsy.…”

“…20 Substantial evidence indicates that the development of macroscopic metastatic cancers requires the capacity to erode and subvert normal tissues and to develop a nurturing vasculature from preexisting blood vessels in adjacent normal tissues. [7][8][9][11][12][13][14]21 Our aim was to perform a systematic review and meta-analysis of the available evidence to investigate the impact of different biopsy procedures on recurrence rates and melanoma-related survival. One large retrospective study 10 reported a decrease in melanoma-specific survival and a higher recurrence rate following a partial biopsy, as compared to excisional biopsy.…”

“…More recent studies concluded that no difference could be observed in melanoma recurrence and survival rates with respect to the biopsy type. [7][8][9][11][12][13][14]21 Our aim was to perform a systematic review and meta-analysis of the available evidence to investigate the impact of different biopsy procedures on recurrence rates and melanoma-related survival.…”