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1 Versus 2-cm Excision Margins for pT2-pT4 Primary Cutaneous Melanoma (MelMarT): A Feasibility Study.
Moncrieff, Marc D; Gyorki, David; Saw, Robyn; Spillane, Andrew J; Thompson, John F; Peach, Howard; Oudit, Deemesh; Geh, Jenny; Dziewulski, Peter; Wilson, Ewan; Matteucci, Paolo; Pritchard-Jones, Rowan; Olofsson Bagge, Roger; Wright, Frances C; Crampton, Nic; Cassell, Oliver; Jallali, Navid; Berger, Adam; Kelly, John; Hamilton, Stephen; Durrani, Amer; Lo, Serigne; Paton, Elizabeth; Henderson, Michael A.
Afiliación
  • Moncrieff MD; Norfolk & Norwich University Hospital, Norwich, UK. marc.moncrieff@nnuh.nhs.uk.
  • Gyorki D; Peter MacCallum Cancer Centre, Melbourne, Australia.
  • Saw R; Melanoma Institute Australia, Sydney, Australia.
  • Spillane AJ; Melanoma Institute Australia, Sydney, Australia.
  • Peach H; Leeds Teaching Hospitals, Leeds, UK.
  • Oudit D; Christie NHS Trust, Manchester, UK.
  • Geh J; Guy's & St Thomas's NHS Trust, London, UK.
  • Dziewulski P; St Andrew's Centre for Burns & Plastic Surgery, Chelmsford, UK.
  • Wilson E; North Bristol NHS Trust, Bristol, UK.
  • Matteucci P; Hull & East Yorkshire NHS Trust, Hull, UK.
  • Pritchard-Jones R; Mersey Centre for Burns & Plastic Surgery, Liverpool, UK.
  • Olofsson Bagge R; Sahlgrenska University Hospital, Göteborg, Sweden.
  • Wright FC; Sunnybrook Health Sciences Centre, Toronto, Canada.
  • Crampton N; Gold Coast Melanoma Clinic, Queensland, Australia.
  • Cassell O; Oxford University Hospitals NHS Trust, Oxford, UK.
  • Jallali N; Imperial Hospital NHS Trust, London, UK.
  • Berger A; Jefferson University Hospitals, Philadelphia, USA.
  • Kelly J; The Alfred Hospital, Melbourne, Australia.
  • Hamilton S; Royal Free Hospital NHS Trust, London, UK.
  • Durrani A; Cambridge University Hospitals, Cambridge, UK.
  • Lo S; Melanoma Institute Australia, Sydney, Australia.
  • Paton E; Australia & New Zealand Melanoma Trials Group, North Sydney, Australia.
  • Henderson MA; Melanoma Institute Australia, Sydney, Australia.
Ann Surg Oncol ; 25(9): 2541-2549, 2018 09.
Article en En | MEDLINE | ID: mdl-29850955
BACKGROUND: There is a lack of consensus regarding optimal surgical excision margins for primary cutaneous melanoma > 1 mm in Breslow thickness (BT). A narrower surgical margin is expected to be associated with lower morbidity, improved quality of life (QoL), and reduced cost. We report the results of a pilot international study (MelMarT) comparing a 1 versus 2-cm surgical margin for patients with primary melanoma > 1 mm in BT. METHODS: This phase III, multicentre trial [NCT02385214] administered by the Australia & New Zealand Medical Trials Group (ANZMTG 03.12) randomised patients with a primary cutaneous melanoma > 1 mm in BT to a 1 versus 2-cm wide excision margin to be performed with sentinel lymph node biopsy. Surgical closure technique was at the discretion of the treating surgeon. Patients' QoL was measured (FACT-M questionnaire) at baseline, 3, 6, and 12 months after randomisation. RESULTS: Between January 2015 and June 2016, 400 patients were randomised from 17 centres in 5 countries. A total of 377 patients were available for analysis. Primary melanomas were located on the trunk (56.9%), extremities (35.6%), and head and neck (7.4%). More patients in the 2-cm margin group required reconstruction (34.9 vs. 13.6%; p < 0.0001). There was an increased wound necrosis rate in the 2-cm arm (0.5 vs. 3.6%; p = 0.036). After 12 months' follow-up, no differences were noted in QoL between groups. DISCUSSION: This pilot study demonstrates the feasibility of a large international RCT to provide a definitive answer to the optimal excision margin for patients with intermediate- to high-risk primary cutaneous melanoma.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de Vida / Piel / Neoplasias Cutáneas / Márgenes de Escisión / Neoplasias de Cabeza y Cuello / Melanoma Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de Vida / Piel / Neoplasias Cutáneas / Márgenes de Escisión / Neoplasias de Cabeza y Cuello / Melanoma Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos