Clinical size is a poor predictor of invasion in melanoma of the lentigo maligna type

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:84

Article

Navarrete-Dechent, Cristian^1,2  Aleissa, Saud¹  Connolly, Karen¹  Hibler, Brian P.¹  Dusza, Stephen W.¹  Rossi, Anthony M.^1,3  Lee, Erica¹  Nehal, Kishwer S.^1,3 

[1] Mem Sloan Kettering Canc Ctr, Dept Med, Dermatol Serv, 545 E 73rd St, New York, NY 10021 USA

[2] Pontificia Univ Catolica Chile, Dept Dermatol, Escuela Med, Santiago, Chile

[3] Weill Cornell Med Coll, New York, NY USA

关键词: Breslow;    invasion;    head and neck;    lentigo maligna;    lentigo maligna melanoma;    melanoma;    prognosis;   

DOI  :  10.1016/j.jaad.2020.10.023

来源: Elsevier

【 摘 要 】

Background: There are no well-defined clinical factors to predict the risk of occult invasion in melanoma of the lentigo maligna type (LM) before complete histopathologic analysis. Objective: To evaluate whether clinical size was a predictor of invasion in LM and subclinical extension. Methods: Consecutive cases of LM were recorded in a prospectively maintained database from 2006 to 2019. Patient and tumor data were recorded during initial evaluation. The LM clinical area was calculated in square millimeters (length X width). All patients were treated with staged excision. Results: We included 600 patients. The mean age was 65.9 years (standard deviation, 12.3; range, 27-95 years); 62.8% (n = 377) were men. The mean LM clinical area was 128.32 mm(2) for in situ lesions versus 200.14 mm for invasive lesions (P = .1). Based on quantile regression, the median margin required for complete removal increased with LM clinical area. Limitations: The study was performed in a tertiary cancer center with possible referral bias and more complex cases. Conclusions: LM can present with variable clinical size, which may correlate with subclinical extension; however, the presence of invasion is not well estimated by LM clinical area.

【 授权许可】

Free