The pathogenesis of local recurrence of melanoma at the primary excision site

Heenan, Peter J.; Ghaznawie, Mahmud

doi:10.1054/bjps.1998.3050

Cited by 54 publications

(35 citation statements)

References 25 publications

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“…In adequately treated primary melanoma, the terms local recurrence, local metastasis, in-transit metastasis and satellite metastasis are all likely to reflect the same biological process of intralymphatic spread beyond the site of therapeutic excision [55]. Since all are characterised by poor prognosis, they should be treated similarly, and are best collectively referred to as in-transit metastases (ITM).…”

Section: Surgery Of Locoregional Recurrencesmentioning

confidence: 99%

Surgery and radiotherapy in the treatment of cutaneous melanoma

et al. 2009

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Adequate surgical management of primary melanoma and regional lymph node metastasis, and rarely distant metastasis, is the only established curative treatment. Surgical management of primary melanomas consists of excisions with 1–2 cm margins and primary closure. The recommended method of biopsy is excisional biopsy with a 2 mm margin and a small amount of subcutaneous fat. In specific situations (very large lesions or certain anatomical areas), full-thickness incisional or punch biopsy may be acceptable. Sentinel lymph node biopsy provides accurate staging information for patients with clinically unaffected regional nodes and without distant metastases, although survival benefit has not been proved. In cases of positive sentinel node biopsy or clinically detected regional nodal metastases (palpable, positive cytology or histopathology), radical removal of lymph nodes of the involved basin is indicated. For resectable local/in-transit recurrences, excision with a clear margin is recommended. For numerous or unresectable in-transit metastases of the extremities, isolated limb perfusion or infusion with melphalan should be considered. Decisions about surgery of distant metastases should be based on individual circumstances. Radiotherapy is indicated as a treatment option in select patients with lentigo maligna melanoma and as an adjuvant in select patients with regional metastatic disease. Radiotherapy is also indicated for palliation, especially in bone and brain metastases.

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Section: Surgery Of Locoregional Recurrencesmentioning

confidence: 99%

Surgery and radiotherapy in the treatment of cutaneous melanoma

et al. 2009

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“…The third was not available for analysis. In all, 4 patients with neoplasm present at the initial resection margin had histologic evidence of persistence at the original site (true local recurrence) 16 including the lesion where completeness of reexcision was not able to be verified.…”

Section: Histopathologic Characteristicsmentioning

confidence: 99%

A clinicopathologic review of lethal nonmelanoma skin cancers in Western Australia

Nolan¹,

Chan

Heenan

2005

Journal of the American Academy of Dermatology

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“…Although tumor deposits becoming trapped along the lymphatic drainage remains the most likely biological explanation, other mechanisms have been suggested, including hematogenous spread, similar to that of distant metastases. 8,9 Supporters of this alternative theory argue that, if the lymphatic concept is true, wider margins during primary excision would be expected to include a higher proportion of trapped occult cells and lead to superior clinical outcomes, which is not consistent with current observations. However, the hematogenous theory is not supported by the significant differences in long-term survival observed for patients with stage III versus stage IV disease.…”

Section: Introductionmentioning

confidence: 70%