Positive margins after surgical excision of locoregional cutaneous melanoma metastasis and their impact on patient outcome

Eur J Dermatol. 2018 Oct 1;28(5):661-667. doi: 10.1684/ejd.2018.3402.

Abstract

For melanoma patients, surgery is a standard treatment for locoregional skin metastasis (LSM). To assess the frequency and risk factors for positive margins after excision of LSM and their impact on patient overall survival (OS) and progression-free survival (PFS). A monocentric, retrospective observational study was performed including 87 patients with LSM who had undergone surgical excision. Positive margins were found in 45% of patients after excision. After additional excision, 28% of patients still had positive margins. Interestingly, there was no difference in PFS or OS for clear margins after the first or additional excision or for margins that remained positive without additional excision. LSM size was the only identified predictive factor for positive margins. This is the first reported study investigating the frequency of, and risk factors for positive margins of cutaneous LSM, which raises the question of whether additional excision should be performed following positive margin excision.

Keywords: locoregional skin metastasis; melanoma; overall survival; positive margin; progression-free survival; risk factor; surgery.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Dermatologic Surgical Procedures / methods
  • Disease-Free Survival
  • Female
  • France
  • Humans
  • Lymphatic Metastasis
  • Male
  • Margins of Excision*
  • Melanoma / mortality*
  • Melanoma / pathology
  • Melanoma / surgery*
  • Melanoma, Cutaneous Malignant
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness / pathology
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Skin Neoplasms / mortality*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / surgery*
  • Survival Rate