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Lentigo maligna melanoma mapping using reflectance confocal microscopy correlates with staged excision: A prospective study.
Navarrete-Dechent, Cristian; Cordova, Miguel; Aleissa, Saud; Liopyris, Konstantinos; Dusza, Stephen W; Kose, Kivanc; Busam, Klaus J; Hollman, Travis; Lezcano, Cecilia; Pulitzer, Melissa; Chen, Chih-Shan J; Lee, Erica H; Rossi, Anthony M; Nehal, Kishwer S.
Afiliação
  • Navarrete-Dechent C; Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • Cordova M; Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • Aleissa S; Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • Liopyris K; Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.
  • Dusza SW; Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • Kose K; Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • Busam KJ; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • Hollman T; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • Lezcano C; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • Pulitzer M; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • Chen CJ; Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • Lee EH; Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • Rossi AM; Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • Nehal KS; Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. Electronic address: nehalk@mskcc.org.
J Am Acad Dermatol ; 2019 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-31812621
ABSTRACT

BACKGROUND:

Lentigo maligna/lentigo maligna melanoma (LM/LMM) can present with subclinical extension that may be difficult to define preoperatively and lead to incomplete excision and potential recurrence. Preliminarily studies have used reflectance confocal microscopy (RCM) to assess LM/LMM margins.

OBJECTIVE:

To evaluate the correlation of LM/LMM subclinical extension defined by RCM compared to the gold standard histopathology.

METHODS:

Prospective study of LM/LMM patients referred for dermatologic surgery. RCM was performed at the clinically-defined initial surgical margin followed by margin-controlled staged excision with paraffin-embedded tissue and histopathology was correlated with RCM results.

RESULTS:

Seventy-two patients were included. Mean age was 66.8 years (SD 11.1; 38 - 89 years); 69.4% were males. 70/72 (97.2%) lesions were located on the head neck with mean largest clinical diameter of 1.3cm (0.3 - 5 cm). Diagnostic accuracy for detection of residual melanoma in the tumor debulk (after biopsy) had a sensitivity of 96.7% and a specificity of 66.7% when compared to the histopathology. RCM margin assessment revealed an overall agreement with final histopathology of 85.9% (kappa 0.71; p<0.001).

LIMITATIONS:

No RCM imaging beyond initial planned margins was performed.

CONCLUSION:

RCM showed moderate to excellent overall agreement between RCM imaging of LM/LMM and histopathology of staged excision margins.
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Idioma: Inglês Ano de publicação: 2019 Tipo de documento: Artigo País de afiliação: Estados Unidos

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Idioma: Inglês Ano de publicação: 2019 Tipo de documento: Artigo País de afiliação: Estados Unidos
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