Melanoma of the Face and Mohs Micrographic Surgery: Nationwide Mortality Data Analysis

Trofymenko, Oleksandr; Bordeaux, Jeremy S.; Zeitouni, Nathalie C.

doi:10.1097/dss.0000000000001429

Cited by 28 publications

(43 citation statements)

References 30 publications

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“…Notably, our study analysed selected patients with lower‐extremity MMs, which were mostly ALMs with poor prognoses and necessitated inguinal SLNBs. Moreover, our data indirectly allude to more favourable results obtained via MMS than in previous studies …”

Section: Discussionsupporting

confidence: 80%

“…reviewed the outcomes of 625 patients with melanoma and found that MMS had several advantages over conventional surgery, including low local recurrence rates and smaller wounds. In our study, the local recurrence rate after MMS was 7%, which is also very low compared with previously reported rates and highlights the effectiveness of MMS for successfully managing acral melanoma.…”

Section: Discussioncontrasting

confidence: 56%

“…reported no significant differences in disease‐specific 5‐year survival in patients who underwent WLE and those with lesions resected with MMS (83% in WLE vs. 92% in MMS; P = 0·59). Similarly, an analysis by Trofymenko et al . of 43 443 patients with melanoma revealed comparable melanoma‐specific mortality or OS outcomes in patients who underwent MMS and those who received other surgical modalities.…”

Section: Discussionmentioning

confidence: 81%

“…Although no prospective randomized trials have been performed to investigate whether MMS is more effective than WLE, the currently available data attest to the value and advantages of MMS for the treatment of MM . In a retrospective review of 151 patients with facial invasive melanoma, Chin‐Lenn et al .…”

Section: Discussionmentioning

confidence: 99%

“…Guidelines for the treatment of MM published by the American Academy of Dermatology highlight the importance of complete tumour removal and SLNB. The use of Mohs micrographic surgery (MMS) for tumour removal in patients with MM is controversial, but MMS can preserve normal tissue and yields similar disease‐free survival (DFS) and overall survival (OS) outcomes to wide local excision (WLE) …”

mentioning

confidence: 99%

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Efficacy and clinical significance of omitting blue dye injection during sentinel lymph node biopsy before Mohs micrographic surgery for malignant melanoma of the lower extremities

Kim

Seo

et al. 2019

Br J Dermatol

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Summary Background Sentinel lymph node biopsy (SLNB) is usually performed using a triple technique that includes lymphoscintigraphy (LSG), which involves the injection of a radiolabelled tracer, blue dye injection, and detection of the radioisotope with a gamma probe. However, blue dye injection may cause pathological misinterpretation and obscure clinical margins, especially when combined with Mohs micrographic surgery (MMS) for cutaneous melanoma. Objectives To assess the efficacy of SLNB without blue dye injection in patients who subsequently underwent MMS for melanomas of the lower extremities. Methods We evaluated patients who underwent MMS with or without SLNB using preoperative localization of the primary melanoma via LSG and intraoperative confirmation using a gamma probe between 2010 and 2016. Results Seventy‐two patients with melanoma of mean Breslow thickness 3·03 ± 1·44 mm were evaluated. Sixty‐five of the 72 patients underwent SLNB, the success rate of which was 98%. The 5‐year overall and disease‐free survival rates were 78% and 76%, respectively. Conclusions Blue dye injection can be omitted without compromising the accuracy of standard SLNB. Omitting blue dye injection also has marked advantages in MMS for melanoma. What's already known about this topic? Sentinel lymph node biopsy (SLNB) is usually performed using a triple technique including lymphoscintigraphy, which involves the injection of a radiolabelled tracer, blue dye injection, and radioisotope detection using a gamma probe. Blue dye injection may cause pathological misinterpretation and obscure clinical margins. What does this study add? Omitting the dye does not decrease diagnostic accuracy and is particularly advantageous for Mohs micrographic surgery (MMS) in melanomas with clinically indistinct tumour borders. SLNB without blue dye injection is feasible in MMS for melanoma.

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Section: Discussionsupporting

confidence: 80%

Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Efficacy and clinical significance of omitting blue dye injection during sentinel lymph node biopsy before Mohs micrographic surgery for malignant melanoma of the lower extremities

Kim

Seo

et al. 2019

Br J Dermatol

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Evolution of Excisional Surgery Practices for Melanoma in the United States

et al. 2019

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guidelines for melanoma have consistently recommended wide local excision as the standard of care since their inception. Although surgery with more comprehensive margin assessment (eg, Mohs surgery) has been advocated for certain subsets of melanoma, how often these techniques are used in clinical practice is uncertain. OBJECTIVE To examine trends in the use of comprehensive margin assessment surgery for melanoma by tracking claims data for Mohs surgery. DESIGN, SETTING, AND PARTICIPANTS This national cross-sectional analysis examined claims data from the Optum Clinformatics Data Mart, a nationally representative database.

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Mohs Micrographic Surgery for Melanoma

2019

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Melanoma of the Face and Mohs Micrographic Surgery: Nationwide Mortality Data Analysis

Abstract: Patients with melanoma of the face treated with MMS had similar melanoma-specific mortality or overall survival outcome as patients treated by other surgical modalities.

Cited by 28 publications

References 30 publications

Efficacy and clinical significance of omitting blue dye injection during sentinel lymph node biopsy before Mohs micrographic surgery for malignant melanoma of the lower extremities

Efficacy and clinical significance of omitting blue dye injection during sentinel lymph node biopsy before Mohs micrographic surgery for malignant melanoma of the lower extremities

Evolution of Excisional Surgery Practices for Melanoma in the United States

Mohs Micrographic Surgery for Melanoma

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