Excision margins for melanoma in situ on the head and neck-A single-center 10-year retrospective review of treatment with Mohs micrographic surgery.
J Am Acad Dermatol
; 90(6): 1226-1231, 2024 Jun.
Article
in En
| MEDLINE
| ID: mdl-38253130
ABSTRACT
BACKGROUND:
Although current guidelines recommend a 5 mm surgical margin for the excision of melanoma in situ (MIS), increasing evidence has shown this may be suboptimal to achieve tumor clearance.OBJECTIVE:
To evaluate margins required for optimal cure rates with excision of MIS on the head and neck and investigate tumor and/or patient factors in those requiring >5 mm margins to achieve tumor clearance.METHODS:
A retrospective chart review was performed on 846 (807 primary and 39 recurrent) MIS cases on the head and neck treated in the authors' dermatologic surgery department over a 126-month (10.5 year) period.RESULTS:
Sixty-two percent were cleared with 5 mm margins. A total of 15 mm margins were required to achieve a 97% clearance rate. Difference in clearance rate between margin thresholds was significant (P < .001). Tumor location on the cheek and larger preoperative size correlated with requiring >5 mm margins to achieve tumor clearance (P = .006 and P = .001, respectively).LIMITATIONS:
This is a single-center retrospective study which relies on accurate documentation of clinical data.CONCLUSION:
This study demonstrates that MIS on the head and neck often requires margins >5 mm margins to achieve tumor clearance. When Mohs micrographic surgery is not possible, excision margins of ≥10 mm are likely necessary for head and neck tumors.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Skin Neoplasms
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Mohs Surgery
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Margins of Excision
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Head and Neck Neoplasms
/
Melanoma
Type of study:
Guideline
/
Observational_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Year:
2024
Type:
Article