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Considerations for Timing of Defect Reconstruction in Cutaneous Melanoma of the Head and Neck.
Namin, Arya W; Cornell, Georgeanne E; Smith, Emily H; Zitsch, Robert P.
Afiliación
  • Namin AW; Department of Otolaryngology - Head and Neck Surgery, University of Missouri, Columbia, Missouri.
  • Cornell GE; Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
  • Smith EH; Department of Dermatology, University of Missouri, Columbia, Missouri.
  • Zitsch RP; Department of Otolaryngology - Head and Neck Surgery, University of Missouri, Columbia, Missouri.
Facial Plast Surg ; 35(4): 404-409, 2019 Aug.
Article en En | MEDLINE | ID: mdl-31315133
The objective of this study is to identify the incidence and characteristics of cases with positive margins on wide local excision for cutaneous melanoma of the head and neck (CMHN) and therefore provide a potential basis for selectively delaying reconstruction pending final histological clearance of melanoma. A systematic review of English language articles was performed on studies retrieved from PubMed and Web of Science. Original investigations published between July 1999 and June 2018 reporting on margin status of CMHN wide local excision specimens were included in the review. The incidence of positive margins after definitive resection for cutaneous melanoma in the literature ranges from 6 to 20.9%. The incidence is higher in cases of advanced patient age, diagnosis by shave biopsy, lentigo maligna melanoma subtype, desmoplastic subtype, tumor thickness, and ulceration. Delayed reconstruction remains the most oncologically sound decision, allowing for interpretation of margin status on paraffin-embedded tissue sections. However, resection and the resultant defect closure in a single stage is more expedient and potentially a more efficient use of resources. The risk-benefit ratio of immediate versus delayed reconstruction must be considered for each case. The incidence of positive margins is higher in cases of advanced patient age, diagnosis by shave biopsy, lentigo maligna melanoma subtype, desmoplastic subtype, increasing tumor thickness, and the presence of ulceration; delayed reconstruction should be strongly considered in these cases.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Cutáneas / Procedimientos de Cirugía Plástica / Neoplasias de Cabeza y Cuello / Melanoma Tipo de estudio: Prognostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Facial Plast Surg Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Cutáneas / Procedimientos de Cirugía Plástica / Neoplasias de Cabeza y Cuello / Melanoma Tipo de estudio: Prognostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Facial Plast Surg Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos