Narrow Resection of Cutaneous Melanoma

1998 ◽  
Vol 2 (3) ◽  
pp. 133-137 ◽  
Author(s):  
K. Beasley ◽  
R.C. Cartotto
Keyword(s):  
Local Recurrence ◽  
Cutaneous Melanoma ◽  
Primary Melanoma ◽  
Extent Of Resection ◽  
Resection Margins ◽  
Progressive Reduction ◽  
Recurrence Rates ◽  
Primary Cutaneous Melanoma ◽  
Intermediate Group ◽  
The Relationship

Background: There has been a progressive reduction in the extent of resection of primary cutaneous melanoma. Although overall survival appears to have been unaffected by this trend, the effect of narrow resection on local recurrence is not entirely clear. Objective: To examine the relationship between narrow resection margins and local recurrence of primary cutaneous melanoma. Methods: Primary melanoma, 104 cases, treated by surgical resection were reviewed retrospectively. Results: “Thin” (< 1 mm) melanomas (31 cases) were resected with a mean margin of 0.87 cm; “intermediate” (1–4 mm) melanomas (37 cases) were resected with a mean margin of 1.26 cm; and 14 “thick” (> 4 mm) melanomas were resected with a mean margin of 1.25 cm. Local recurrence rates were 6.5%, 16.2%, and 42.9%, respectively. In the “intermediate” group, two local recurrences occurred in melanomas < 2 mm thick despite use of margins of 1.7 cm and 2.4 cm. Conclusions: The results do not support the use of excessively narrow resection margins around primary cutaneous melanoma. Additionally, we question the true safety of currently accepted 1 to 2 cm margins for 1 to 2 mm thick melanomas.

scholarly journals Radiation-Associated Angiosarcoma of the Breast and Chest Wall Treated with Thermography-Controlled, Contactless wIRA-Hyperthermia and Hypofractionated Re-Irradiation

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3911
Author(s):  
Markus Notter ◽  
Emanuel Stutz ◽  
Andreas R. Thomsen ◽  
Peter Vaupel
Keyword(s):  
Local Recurrence ◽  
Background Radiation ◽  
Definitive Treatment ◽  
Resection Margins ◽  
Recurrence Rates ◽  
Rate Dependent ◽  
Angiosarcoma Of The Breast ◽  
Positive Resection Margins ◽  
Locally Recurrent ◽  
Tumor Extent

Background: Radiation-associated angiosarcoma of the breast (RAASB) is a rare, challenging disease, with surgery being the accepted basic therapeutic approach. In contrast, the role of adjuvant and systemic therapies is a subject of some controversy. Local recurrence rates reported in the literature are mostly heterogeneous and are highly dependent on the extent of surgery. In cases of locally recurrent or unresectable RAASB, prognosis is very poor. Methods: We retrospectively report on 10 consecutive RAASB patients, most of them presenting with locally recurrent or unresectable RAASB, which were treated with thermography-controlled water-filtered infrared-A (wIRA) superficial hyperthermia (HT) immediately followed by re-irradiation (re-RT). Patients with RAASB were graded based on their tumor extent before onset of radiotherapy (RT). Results: We recorded a local control (LC) rate dependent on tumor extent ranging from a high LC rate of 100% (two of two patients) in the adjuvant setting with an R0 or R2 resection to a limited LC rate of 33% (one of three patients) in patients with inoperable, macroscopic tumor lesions. Conclusion: Combined HT and re-RT should be considered as an option (a) for adjuvant treatment of RAASB, especially in cases with positive resection margins and after surgery of local recurrence (LR), and (b) for definitive treatment of unresectable RAASB.

Humoral Immune Response to a Therapeutic Polyvalent Cancer Vaccine After Complete Resection of Thick Primary Melanoma and Sentinel Lymphadenectomy

2003 ◽  
Vol 21 (2) ◽  
pp. 313-319 ◽  
Author(s):  
Mathew H. Chung ◽  
Rishab K. Gupta ◽  
Eddy Hsueh ◽  
Richard Essner ◽  
Wei Ye ◽  
...  
Keyword(s):  
Immune Responses ◽  
Cancer Vaccine ◽  
Cutaneous Melanoma ◽  
Univariate Analysis ◽  
Primary Melanoma ◽  
Vaccine Therapy ◽  
Enzyme Linked Immunosorbent Assay ◽  
High Dose ◽  
Primary Cutaneous Melanoma ◽  
Sentinel Lymphadenectomy

Purpose: A therapeutic polyvalent cancer vaccine (Canvaxin vaccine; CancerVax Corp, Carlsbad, CA) induces antibodies to a glycoprotein tumor-associated antigen (TA90). However, endogenous immune responses to TA90 have also been reported. This study examined anti-TA90 antibody responses with respect to the survival of patients who received adjuvant vaccine immunotherapy after resection of thick (≥ 4 mm) primary cutaneous melanoma. Patients and Methods: Serum specimens were obtained from 54 patients immediately before and then 1, 2, 4, and 6 months after wide local excision of thick primary cutaneous melanoma and sentinel lymphadenectomy. All patients were offered adjuvant therapies with the vaccine, high-dose interferon, or other agents. An enzyme-linked immunosorbent assay was used to determine serial serum titers of immunoglobulin G (IgG) and IgM antibodies against TA90. These titers were correlated with clinical course. Results: Forty-three patients chose vaccine therapy, and 11 patients chose postoperative observation. Preoperative anti-TA90 IgG and IgM titers were similar for vaccine and observation groups (P = .184). At a median follow-up of 26 months, univariate analysis of Cox regression showed that disease-free survival and overall survival of vaccine patients were significantly correlated with maximal IgM response (P = .0006 and .006, respectively) but not with maximal IgG response (P = .73 and .95, respectively). Neither response predicted survival in the observation group. Conclusion: Postoperative vaccine therapy may enhance IgG and IgM immune responses to TA90 after surgical resection, but only the IgM response is correlated with improved survival. These findings may become useful to guide selection of patients for postoperative adjuvant therapy of high-risk melanoma.

A study into the association between local recurrence rates and surgical resection margins in organ-sparing surgery for penile squamous cell cancer

2018 ◽  
Vol 122 (4) ◽  
pp. 576-582 ◽  
Author(s):  
Denosshan Sri ◽  
Arunan Sujenthiran ◽  
Wayne Lam ◽  
Janice Minter ◽  
Brendan E. Tinwell ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Surgical Resection ◽  
Squamous Cell ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Resection Margins ◽  
Recurrence Rates ◽  
Organ Sparing

Excision Margin and Survival in Patients with High-Risk, Primary Cutaneous Melanoma: A Retrospective Study Based on Surveillance Epidemiology and End Result (SEER) Database

Dermatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Meng-Nan Xu ◽  
Qiu Rao
Keyword(s):  
High Risk ◽  
Cutaneous Melanoma ◽  
Primary Melanoma ◽  
Surgical Excision ◽  
Primary Cutaneous Melanoma ◽  
Term Survival ◽  
Wide Margin ◽  
Excision Margin ◽  
Therapeutic Benefits ◽  
Excision Margins

<b><i>Objectives:</i></b> The optimal excision margin of primary cutaneous melanoma greater than 2 mm in thickness is still a controversial topic. The aim of the present study was to compare the long-term survival between narrow and wide excision margins in the surgical excision of patients with high-risk primary melanoma. <b><i>Methods:</i></b> We chose the patients with primary melanoma of the skin thicker than 2 mm in The Surveillance, Epidemiology, and End Results database. Patients were divided into a narrow margin group (1–2 cm) and a wide margin group (&#x3e;2 cm) according to the resection margin information. The primary outcome was overall survival and disease-specific survival. <b><i>Results:</i></b> From 2004 to 2015, a total of 2,772 patients diagnosed as having melanoma of the skin were recruited into this study and were assigned to the narrow margin group (<i>n</i> = 1996) and the wide margin group (<i>n</i> = 776). A total of 1,098 patients died during the follow-up, and 681 of these were due to melanoma. There were 779 deaths in the narrow margin group and 319 deaths in the wide margin group (HR: 0.96, 95% CI: 0.84–1.10, <i>p</i> = 0.26). A total of 490 melanoma-specific deaths were reported in the narrow margin group and 191 were reported in the wide margin group (HR: 1.01, 95% CI: 0.85–1.19, <i>p</i> = 0.91). <b><i>Conclusions:</i></b> Wider excision margin greater than 2 cm did not provide any additional therapeutic benefits compared to narrow excision margin between 1 and 2 cm. A 2-cm margin is adequate and safe for high-risk primary melanoma of the skin thicker than 2 mm.

scholarly journals The influence of surgical margins and prognostic factors predicting the risk of local recurrence in 3445 patients with primary cutaneous melanoma

Cancer ◽  
1985 ◽  
Vol 55 (6) ◽  
pp. 1398-1402 ◽  
Author(s):  
Marshall M. Urist ◽  
Charles M. Balch ◽  
Seng-Jaw Soong ◽  
Helen M. Shaw ◽  
Gerald W. Milton ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Local Recurrence ◽  
Cutaneous Melanoma ◽  
Surgical Margins ◽  
Primary Cutaneous Melanoma

Tumor

2020 ◽  
pp. 171-208
Keyword(s):  
Stem Cell ◽  
Whole Brain Radiotherapy ◽  
Extent Of Resection ◽  
Grading System ◽  
Language Mapping ◽  
Recurrence Rates ◽  
The Third ◽  
Brain Radiotherapy ◽  
Glioma Resection ◽  
The Relationship

This chapter focuses on neurosurgical oncology. The first set of studies explores various preoperative parameters that impact survival in patients with glioblastoma multiforme, identifies a cancer stem cell in human brain tumors, and demonstrates the importance of language mapping for glioma resection and its impact on functional outcomes. The second set of studies provides an analysis of the recurrence and progression of meningioma. The third set of studies evaluates the efficacy of surgery, whole-brain radiotherapy, and stereotactic radiosurgery in the treatment of patients with brain metastases. The last study, included for its historical value, is Dr. Simpson's paper in which he proposed a grading system for the recurrence rates of meningiomas but also the relationship between these rates and extent of resection of meningioma.

Angiotropism is an Independent Predictor of Local Recurrence and In-transit Metastasis in Primary Cutaneous Melanoma

2008 ◽  
Vol 32 (9) ◽  
pp. 1396-1403 ◽  
Author(s):  
Simone L. Van Es ◽  
Marjorie Colman ◽  
John F. Thompson ◽  
Stanley W. McCarthy ◽  
Richard A. Scolyer
Keyword(s):  
Local Recurrence ◽  
Cutaneous Melanoma ◽  
Independent Predictor ◽  
Primary Cutaneous Melanoma ◽  
In Transit

scholarly journals Multiple Primary Melanoma Incidence Trends Over Five Decades: A Nationwide Population-Based Study

2020 ◽  
Author(s):  
Hildur Helgadottir ◽  
Karolin Isaksson ◽  
Ildiko Fritz ◽  
Christian Ingvar ◽  
Jan Lapins ◽  
...  
Keyword(s):  
Cutaneous Melanoma ◽  
Statistical Significance ◽  
Primary Melanoma ◽  
Population Based ◽  
Steady Increase ◽  
Second Primary ◽  
Primary Cutaneous Melanoma ◽  
Population Based Study ◽  
Incidence Trends ◽  
The 1960S

Abstract Background Over the past decades, many regions have experienced a steady increase in the incidence of cutaneous melanoma. Here, we report on incidence trends for subsequent primary melanoma. Methods In this nationwide population-based study, patients diagnosed with a first primary cutaneous melanoma reported to the Swedish Cancer Registry were followed for up to 10 years for a diagnosis of subsequent primary melanoma. Patients were grouped with patients diagnosed with first melanoma in the same decade (1960s, 1970s, 1980s, 1990s, and 2000s, respectively). Frequencies, incidence rates (IRs), standardized incidence ratios (SIRs), and 95% confidence intervals (CIs) for second melanomas were calculated. All tests of statistical significance were 2-sided. Results Of patients with melanoma, 54 884 were included and 2469 were diagnosed, within 10 years, with subsequent melanomas. Over the 5 decades, there was a statistically significant steady increase in the frequency, IR, and SIR for second primary melanoma. For example, in the 1960s cohort, less than 1% (IR = 1.0, 95% CI = 0.5 to 1.7, and IR = 1.1, 95% CI = 0.5 to 1.9 per 1000 person-years in women and men, respectively) had second primary melanoma, and this rose to 6.4% (IR = 7.5, 95% CI = 6.8 to 8.3, per 1000 person-years) in the women and 7.9% (IR = 10.3, 95% CI = 9.3 to 11.2, per 1000 person-years) in the men in the 2000s cohort. This rise was seen independent of age, sex, invasiveness, or site of the melanoma. Further, in patients diagnosed with a second melanoma, the frequency of those having more than 2 melanomas increased statistically significantly and was 0.0% in the 1960s and rose to 18.0% in the 2000s (P &lt; .001). Conclusions This is the first study to evaluate and report on a rising trend for subsequent primary melanoma. Additional primary melanomas worsen the patients’ survival, and precautions are needed to turn this steep upgoing trend.

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