Risk of recurrence of nail unit melanoma after functional surgery versus amputation.
J Am Acad Dermatol
; 88(5): 1017-1023, 2023 05.
Article
en En
| MEDLINE
| ID: mdl-36642330
ABSTRACT
BACKGROUND:
Minimally invasive nail unit melanoma (NUM) can be treated with functional surgery (FS) instead of amputation.OBJECTIVE:
To determine risk factors associated with recurrence in NUM.METHODS:
We retrospectively reviewed patients with NUM between 2008 and 2022 at a tertiary referral center. Multivariable Cox regression models adjusted for male sex and Breslow thickness (BT) were generated. Receiver operating characteristic analysis was performed to determine optimal cut-off points of the BT for stratifying recurrence risk.RESULTS:
We evaluated 140 NUM cases (33 amputation and 107 FS). The mean BT values were 3.14 ± 2.62 mm (amputation) and 0.70 ± 1.36 mm (FS). Recurrence occurred in 10 (30.30%) patients with amputation and 23 (21.5%) with FS. Distant disease occurred in 10 (30.30%) patients with amputation and 8 (7.48%) with FS. Male sex, greater BT, amelanotic color, ulcers, and nodules were associated with greater risk for recurrence or distant disease. A BT of 0.8 mm was deemed the optimal cut-off for stratifying recurrence risk after surgery (odds ratio, 5.32; 95% CI, 2.04-13.85).LIMITATIONS:
Small sample.CONCLUSION:
FS can be considered for NUM with a BT < 0.8 mm, providing an amputation-sparing benefit. However, NUM with risk factors for recurrence requires patient counselling and close follow-ups.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias Cutáneas
/
Melanoma
/
Enfermedades de la Uña
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
/
Male
Idioma:
En
Revista:
J Am Acad Dermatol
Año:
2023
Tipo del documento:
Article