Sheila M Valentín-Nogueras1, David G Brodland, John A Zitelli, Lorena González-Sepúlveda, Cruz M Nazario. 1. *Department of Dermatology, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico; †Departments of Plastic Surgery, Dermatology, and Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; ‡Zitelli and Brodland Skin Cancer Center, Pittsburgh, Pennsylvania; §Puerto Rico Clinical and Translational Research Consortium, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico; ‖Biostatistics and Epidemiology Department, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
Abstract
BACKGROUND: Mohs micrographic surgery (MMS) with melanoma antigen recognized by T-cell (MART-1) immunostaining is an effective treatment of cutaneous melanoma. OBJECTIVE: To determine the efficacy of MMS with MART-1 immunostain in the management of invasive and in situ melanoma. METHODS AND MATERIALS: A retrospective cohort study evaluated 2,114 melanomas in 1,982 patients excised using MMS and MART-1 immunostain. The margins required for excision were calculated based on Breslow thickness, location, and size. Survival and local recurrence rates were calculated and compared with those of historical controls. RESULTS: The mean follow-up period was 3.73 years. Local recurrence was identified in 0.49% (7/1,419) of primary melanomas. Approximately 82% of melanomas were excised with ≤6-mm margins. The surgical margin was significantly related to tumor location and size but not to Breslow thickness. The five-year Kaplan-Meier local recurrence and disease-specific survival rates were 0.59 ± 0.30 and 98.53 ± 0.42, respectively. Mohs micrographic surgery with MART-1 immunostain achieved lower local recurrence rates and equivalent or higher Kaplan-Meier survival rates than conventional wide local excision. CONCLUSION: Mohs micrographic surgery with MART-1 immunostain is an effective treatment of melanoma as evidenced by low local recurrence rates. It offers the advantage of more tissue-conserving margins than those recommended for conventional excision.
BACKGROUND: Mohs micrographic surgery (MMS) with melanoma antigen recognized by T-cell (MART-1) immunostaining is an effective treatment of cutaneous melanoma. OBJECTIVE: To determine the efficacy of MMS with MART-1 immunostain in the management of invasive and in situ melanoma. METHODS AND MATERIALS: A retrospective cohort study evaluated 2,114 melanomas in 1,982 patients excised using MMS and MART-1 immunostain. The margins required for excision were calculated based on Breslow thickness, location, and size. Survival and local recurrence rates were calculated and compared with those of historical controls. RESULTS: The mean follow-up period was 3.73 years. Local recurrence was identified in 0.49% (7/1,419) of primary melanomas. Approximately 82% of melanomas were excised with ≤6-mm margins. The surgical margin was significantly related to tumor location and size but not to Breslow thickness. The five-year Kaplan-Meier local recurrence and disease-specific survival rates were 0.59 ± 0.30 and 98.53 ± 0.42, respectively. Mohs micrographic surgery with MART-1 immunostain achieved lower local recurrence rates and equivalent or higher Kaplan-Meier survival rates than conventional wide local excision. CONCLUSION: Mohs micrographic surgery with MART-1 immunostain is an effective treatment of melanoma as evidenced by low local recurrence rates. It offers the advantage of more tissue-conserving margins than those recommended for conventional excision.
Authors: Suzanne M Connolly; Diane R Baker; Brett M Coldiron; Michael J Fazio; Paul A Storrs; Allison T Vidimos; Mark J Zalla; Jerry D Brewer; Wendy Smith Begolka; Timothy G Berger; Michael Bigby; Jean L Bolognia; David G Brodland; Scott Collins; Terrence A Cronin; Mark V Dahl; Jane M Grant-Kels; C William Hanke; George J Hruza; William D James; Clifford Warren Lober; Elizabeth I McBurney; Scott A Norton; Randall K Roenigk; Ronald G Wheeland; Oliver J Wisco Journal: J Am Acad Dermatol Date: 2012-09-05 Impact factor: 11.527
Authors: U Ringborg; R Andersson; J Eldh; B Glaumann; L Hafström; S Jacobsson; P E Jönsson; H Johansson; L Krysander; B Lagerlöf Journal: Cancer Date: 1996-05-01 Impact factor: 6.860