Incompletely excised lentigo maligna melanoma is associated with unpredictable residual disease: clinical features and the emerging role of reflectance confocal microscopy

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dc.contributor.authorNavarrete-Dechent, C.
dc.contributor.authorAleissa, S.
dc.contributor.authorCordova, M.
dc.contributor.authorLiopyris, K.
dc.contributor.authorLee, E. H.
dc.contributor.authorRossi, A. M.
dc.contributor.authorHollman, T.
dc.contributor.authorPulitzer, M.
dc.contributor.authorLezcano, C.
dc.contributor.authorBusam, K. J.
dc.contributor.authorMarghoob, A. A.
dc.contributor.authorChen, C-C J.
dc.contributor.authorNehal, K. S.
dc.date.accessioned2025-01-23T19:48:57Z
dc.date.available2025-01-23T19:48:57Z
dc.date.issued2020
dc.description.abstractBackground Lentigo maligna/lentigo maligna melanoma (LM/LMM) poses a treatment and surgical challenge given unpredictable subclinical extension resulting in incomplete excision. Objectives To describe the demographic, clinical and pathologic characteristics of incompletely excisedLM/LMM. To evaluate the potential role of reflectance confocal microscopy (RCM). Patients and methods A retrospective review of a melanoma database at a tertiary cancer centre for patients referred with 'incompletely excisedLM/LMM' or 'incompletely excised melanoma' between October 2006 and July 2017. We recorded clinical and pathological data and surgical margins needed to clear the residualLM/LMM. The second part consisted of a prospective cohort of patients in whichRCMwas performed when presenting with incompletely excisedLM/LMM. Results We included a total of 67 patients (retrospective + prospective cohort); mean age was 64.9 (standard deviation: 11.3) years and 52.2% were males. For the retrospective cohort (n = 53), the mean scar size was 3.4 cm. The average initial margins excised prior to presentation were 4.8 mm (range 3-7 mm). The average additional margin needed to clear the residual, incompletely excisedLM/LMMwas 7.8 mm. For the prospective cohort (n = 14), there were no differences in age, gender or size when compared to the retrospective cohort.RCMhad a diagnostic accuracy of 78.6%, a sensitivity of 90.9%, a specificity of 33.3% and a positive predictive value of 83.3% for the detection of incompletely excisedLM/LMM. Conclusions Incompletely excisedLM/LMMis a poorly characterized clinical-pathological scenario that may require considerable extra margins for microscopic clearance.RCMmay emerge as a valuable tool for the evaluation of patients with incompletely excisedLM/LMM.
dc.description.funderNIH/NCI Cancer Center Support Grant
dc.fuente.origenWOS
dc.identifier.doi10.1111/jdv.16272
dc.identifier.eissn1468-3083
dc.identifier.issn0926-9959
dc.identifier.urihttps://doi.org/10.1111/jdv.16272
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/100470
dc.identifier.wosidWOS:000563535300001
dc.issue.numero10
dc.language.isoen
dc.pagina.final2287
dc.pagina.inicio2280
dc.revistaJournal of the european academy of dermatology and venereology
dc.rightsacceso restringido
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleIncompletely excised lentigo maligna melanoma is associated with unpredictable residual disease: clinical features and the emerging role of reflectance confocal microscopy
dc.typeartículo
dc.volumen34
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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