Incisional procedures and prognosis in malignant melanoma

Rampen, F.H.J.; Houten, W.A.; Hop, Wim C. J.

doi:10.1111/j.1365-2230.1980.tb01709.x

Cited by 56 publications

(26 citation statements)

References 13 publications

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“…Ironside et al found a five-year OS rate of 66% in the excision- and 43% in the incision biopsy group but failed to describe the distribution of prognostic factors between both groups 10. Rampen et al also found a worse prognosis for patients after an incision biopsy (14 patients) but the study was small and retrospective 11. Griffiths et al found no difference in survival but 7/19 incisional biopsy patients were excluded because of missing histopathological data 12.…”

Section: Discussionmentioning

confidence: 99%

Non-Radical Diagnostic Biopsies Do Not Negatively Influence Melanoma Patient Survival

et al. 2007

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Background: In fair-skinned Caucasian populations both the incidence and mortality rates of cutaneous melanoma have been increasing over the past decades. With adjuvant therapies still being under investigation, early detection is the only way to improve melanoma patient survival. The influence of incisional biopsies on melanoma patient survival has been discussed for many years. This study investigates both the influence of diagnostic biopsy type and the presence of residual tumor cells in the re-excision specimen on disease free and overall survival.Methods: After (partial) removal of a pigmented skin lesion 471 patients were diagnosed with stage I/II melanoma and underwent re-excision and a sentinel node biopsy. All patients were followed prospectively, mean follow up >5 years. Patients were divided according to their diagnostic biopsy type (wide excision biopsy, narrow excision biopsy, excision biopsy with positive margins and incisional biopsy) and the presence of residual tumor cells in their re-excision specimen. Survival analysis was done using CoxÕs proportional hazard model adjusted for eight important confounders of melanoma patient survival.Results: The diagnostic biopsy was wide in 279 patients, narrow in 109 patients, 52 patients underwent an excision biopsy with positive margins and 31 patients an incisional biopsy. In 41 patients residual tumor cells were present in the re-excision specimen. Both the diagnostic biopsy type and the presence of tumor cells in the re-excision specimen did not influence disease free and overall survival of melanoma patients.Conclusions: Non-radical diagnostic biopsies do not negatively influence melanoma patient survival.

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Section: Discussionmentioning

confidence: 99%

Non-Radical Diagnostic Biopsies Do Not Negatively Influence Melanoma Patient Survival

et al. 2007

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“…However, a pathologic examination of a biopsy of the lesion is required for a definitive diagnosis and determination of the tumor thickness. The influence of the type of biopsy on the patient outcome in melanoma, specifically, whether an incisional biopsy causes local or systemic tumor dissemination, has been debated [5,6,7,89]. Rampen et al [5] reported a decreased survival rate in a group of 14 patients who had incisional biopsies compared with that of 62 patients who had excisional biopsies.…”

Section: Discussionmentioning

confidence: 99%

“…The influence of the type of biopsy on the patient outcome in melanoma, specifically, whether an incisional biopsy causes local or systemic tumor dissemination, has been debated [5,6,7,89]. Rampen et al [5] reported a decreased survival rate in a group of 14 patients who had incisional biopsies compared with that of 62 patients who had excisional biopsies. In a study on head and neck melanomas, Austin et al [6] reported a decreased survival rate among patients who had incisional, shave, or needle aspiration biopsies compared with those who had excisional biopsies, although a significant age difference was noted among the patient groups.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2014

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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.

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“…Concern over local, regional, or systemic metastasis was prompted by prior studies and case reports which suggested a poor outcome for patients undergoing subtotal biopsy techniques. 87,[101][102][103][104][105][106][107][108][109][110][111][112] When comparing 14 patients who underwent incisional biopsy with 62 patients who had an excision for diagnosis in a retrospective study, Rampen, van Houten, and Jop 110 in 1980 were able to demonstrate reduced survival with incisional biopsy. However, they did not stratify for other factors related to survivability between the two groups.…”

Section: Margins and Metastasismentioning

confidence: 99%