Outcomes of invasive melanoma of the head and neck treated with Mohs micrographic surgery – A multicenter study
There are no randomized controlled trials to guide surgical margins for invasive head and neck (H&N) melanoma using conventional excision. Mohs micrographic surgery (MMS) has shown improved local recurrence rates and survival for invasive H&N melanomas. Determine local recurrence (LR), nodal...
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| Published in: | Journal of the American Academy of Dermatology Vol. 89; no. 3; pp. 544 - 550 |
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| Language: | English |
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01-09-2023
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| Abstract | There are no randomized controlled trials to guide surgical margins for invasive head and neck (H&N) melanoma using conventional excision. Mohs micrographic surgery (MMS) has shown improved local recurrence rates and survival for invasive H&N melanomas.
Determine local recurrence (LR), nodal recurrence, and distant recurrence rates, and disease specific survival for invasive melanoma of the H&N treated with MMS.
A retrospective multicenter study of 785 cases of invasive H&N melanoma treated with MMS using frozen sections with melanoma antigen recognized by T-cells 1 immunohistochemical staining was performed to evaluate long-term outcomes over 12-years.
785 melanomas (thickness: 0.3 mm-8.5 mm) were treated with MMS. LR, nodal recurrence, and distant recurrence rates were 0.51% (4/785), 1.0% (8/785), and 1.1% (9/785) respectively. For T1, T2, T3, and T4 tumors LR was 0.16% (1/636), 1.18% (1/85), 2.22% (1/45), and 5.26% (1/19), respectively. Five and 10-year disease specific survival were 96.8% (95% CI 95.0% to 98.5%) and 93.4% (95% CI 88.5% to 98.3%).
A nonrandomized retrospective study.
MMS achieves significant improvements in LR compared to a meta-analysis of historical cohorts of patients treated with conventional excision. MMS should be considered an important surgical option for invasive H&N melanoma. |
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| AbstractList | BACKGROUNDThere are no randomized controlled trials to guide surgical margins for invasive head and neck (H&N) melanoma using conventional excision. Mohs micrographic surgery (MMS) has shown improved local recurrence rates and survival for invasive H&N melanomas.OBJECTIVEDetermine local recurrence (LR), nodal recurrence, and distant recurrence rates, and disease specific survival for invasive melanoma of the H&N treated with MMS.METHODSA retrospective multicenter study of 785 cases of invasive H&N melanoma treated with MMS using frozen sections with melanoma antigen recognized by T-cells 1 immunohistochemical staining was performed to evaluate long-term outcomes over 12-years.RESULTS785 melanomas (thickness: 0.3 mm-8.5 mm) were treated with MMS. LR, nodal recurrence, and distant recurrence rates were 0.51% (4/785), 1.0% (8/785), and 1.1% (9/785) respectively. For T1, T2, T3, and T4 tumors LR was 0.16% (1/636), 1.18% (1/85), 2.22% (1/45), and 5.26% (1/19), respectively. Five and 10-year disease specific survival were 96.8% (95% CI 95.0% to 98.5%) and 93.4% (95% CI 88.5% to 98.3%).LIMITATIONSA nonrandomized retrospective study.CONCLUSIONMMS achieves significant improvements in LR compared to a meta-analysis of historical cohorts of patients treated with conventional excision. MMS should be considered an important surgical option for invasive H&N melanoma. There are no randomized controlled trials to guide surgical margins for invasive head and neck (H&N) melanoma using conventional excision. Mohs micrographic surgery (MMS) has shown improved local recurrence rates and survival for invasive H&N melanomas. Determine local recurrence (LR), nodal recurrence, and distant recurrence rates, and disease specific survival for invasive melanoma of the H&N treated with MMS. A retrospective multicenter study of 785 cases of invasive H&N melanoma treated with MMS using frozen sections with melanoma antigen recognized by T-cells 1 immunohistochemical staining was performed to evaluate long-term outcomes over 12-years. 785 melanomas (thickness: 0.3 mm-8.5 mm) were treated with MMS. LR, nodal recurrence, and distant recurrence rates were 0.51% (4/785), 1.0% (8/785), and 1.1% (9/785) respectively. For T1, T2, T3, and T4 tumors LR was 0.16% (1/636), 1.18% (1/85), 2.22% (1/45), and 5.26% (1/19), respectively. Five and 10-year disease specific survival were 96.8% (95% CI 95.0% to 98.5%) and 93.4% (95% CI 88.5% to 98.3%). A nonrandomized retrospective study. MMS achieves significant improvements in LR compared to a meta-analysis of historical cohorts of patients treated with conventional excision. MMS should be considered an important surgical option for invasive H&N melanoma. |
| Author | Beal, Brandon T. Sobanko, Joseph F. Brodland, David G. Aizman, Leora Shin, Thuzar M. Udkoff, Jeremy Etzkorn, Jeremy Zitelli, John A. Miller, Christopher J. |
| Author_xml | – sequence: 1 givenname: Brandon T. surname: Beal fullname: Beal, Brandon T. email: Brandon.tyler.beal@gmail.com organization: St. Louis Dermatology & Cosmetic Surgery, St. Louis Skin Cancer Specialists, Troy, Missouri – sequence: 2 givenname: Jeremy surname: Udkoff fullname: Udkoff, Jeremy organization: Department of Dermatology, University of Pittsburgh Medical Center, Philadelphia, Pennsylvania – sequence: 3 givenname: Leora surname: Aizman fullname: Aizman, Leora organization: George Washington University School of Medicine and Health Sciences, Washington, District of Columbia – sequence: 4 givenname: Jeremy surname: Etzkorn fullname: Etzkorn, Jeremy organization: Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania – sequence: 5 givenname: John A. surname: Zitelli fullname: Zitelli, John A. organization: University of Pittsburgh Medical Center, Zitelli & Brodland, PC, Pittsburgh, Pennsylvania – sequence: 6 givenname: Christopher J. surname: Miller fullname: Miller, Christopher J. organization: Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania – sequence: 7 givenname: Thuzar M. surname: Shin fullname: Shin, Thuzar M. organization: Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania – sequence: 8 givenname: Joseph F. surname: Sobanko fullname: Sobanko, Joseph F. organization: Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania – sequence: 9 givenname: David G. surname: Brodland fullname: Brodland, David G. organization: University of Pittsburgh Medical Center, Zitelli & Brodland, PC, Pittsburgh, Pennsylvania |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36642331$$D View this record in MEDLINE/PubMed |
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| Keywords | Mohs microscopic surgery NCCN NR LR head and neck invasive melanoma DR DSD AJCC head and neck melanoma head and neck melanoma outcomes CE DSR OS DSS MART-1 ZB melanoma SLNB ICH Penn H&N MMS invasive melanoma RCTs multicenter Mohs surgery |
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| Snippet | There are no randomized controlled trials to guide surgical margins for invasive head and neck (H&N) melanoma using conventional excision. Mohs micrographic... BACKGROUNDThere are no randomized controlled trials to guide surgical margins for invasive head and neck (H&N) melanoma using conventional excision. Mohs... |
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| SubjectTerms | head and neck head and neck invasive melanoma head and neck melanoma Humans invasive melanoma melanoma Melanoma - pathology melanoma outcomes Melanoma, Cutaneous Malignant Mohs microscopic surgery Mohs Surgery multicenter Multicenter Studies as Topic Neoplasm Recurrence, Local - epidemiology Neoplasm Recurrence, Local - surgery Retrospective Studies Skin Neoplasms - pathology Treatment Outcome |
| Title | Outcomes of invasive melanoma of the head and neck treated with Mohs micrographic surgery – A multicenter study |
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