Yannick S Elshot1,2, Biljana Zupan-Kajcovski1, William M C Klop3, Marcel W Bekkenk2, Marianne B Crijns1, Menno A de Rie2, Alfons J M Balm3,4. 1. Department of Dermatology, The Netherlands Cancer Institute, Amsterdam, the Netherlands. 2. Department of Dermatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 3. Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands. 4. Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Abstract
BACKGROUND: The surgical treatment of lentigo maligna melanoma is associated with high rates of local recurrence. Handheld reflectance confocal microscopy (HH-RCM) allows for in vivo presurgical detection of subclinical lentigo maligna (melanoma) (LM/LMM). METHODS: A single-center retrospective study from December 2015 to July 2017. Frequency and extent of negative surgical margins, and the diagnostic accuracy of presurgical mapping by HH-RCM was determined. RESULTS: Twenty-six consecutive patients with LM/LMM were included. In 45.8%, HH-RCM detected subclinical LM with a sensitivity of 0.90 and specificity of 0.86. The management was changed in two (7.7%) patients. Of the 24 remaining lesions, 95.8% were excised with negative margins with a mean histological margin of 3.1 and 5.3 mm for LM and LMM, respectively. At a mean follow-up of 36.7 months, there was one (4.8%) confirmed recurrence. CONCLUSIONS: Our method of presurgical delineation by HH-RCM appears to provide a reliable method for the surgical treatment of LM/LMM with a limited rate of overtreatment.
BACKGROUND: The surgical treatment of lentigo maligna melanoma is associated with high rates of local recurrence. Handheld reflectance confocal microscopy (HH-RCM) allows for in vivo presurgical detection of subclinical lentigo maligna (melanoma) (LM/LMM). METHODS: A single-center retrospective study from December 2015 to July 2017. Frequency and extent of negative surgical margins, and the diagnostic accuracy of presurgical mapping by HH-RCM was determined. RESULTS: Twenty-six consecutive patients with LM/LMM were included. In 45.8%, HH-RCM detected subclinical LM with a sensitivity of 0.90 and specificity of 0.86. The management was changed in two (7.7%) patients. Of the 24 remaining lesions, 95.8% were excised with negative margins with a mean histological margin of 3.1 and 5.3 mm for LM and LMM, respectively. At a mean follow-up of 36.7 months, there was one (4.8%) confirmed recurrence. CONCLUSIONS: Our method of presurgical delineation by HH-RCM appears to provide a reliable method for the surgical treatment of LM/LMM with a limited rate of overtreatment.
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Authors: Yannick S Elshot; Biljana Zupan-Kajcovski; William M C Klop; Marcel W Bekkenk; Marianne B Crijns; Menno A de Rie; Alfons J M Balm Journal: Head Neck Date: 2020-11-24 Impact factor: 3.147
Authors: Yannick S Elshot; Biljana Zupan-Kajcovski; William M C Klop; Marcel W Bekkenk; Marianne B Crijns; Menno A de Rie; Alfons J M Balm Journal: Head Neck Date: 2020-11-24 Impact factor: 3.147