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Head and neck cutaneous melanoma: an influence of surgical resection margin on long-term results
oleh: M B Pak, A M Mudunov, L V Demidov, R I Azizyan, V Zh Brzhezovskiy, D K Stelmah, Yu V Alymov, A V Ignatova
| Format: | Article |
|---|---|
| Diterbitkan: | IP Habib O.N. 2017-12-01 |
Deskripsi
Introduction. Despite of recent breakthrough in the drug therapy of metastatic melanoma surgical treatment remains the key method of treatment of primary cutaneous melanoma. Resection margin of ≥3 centimeters has been considered as radical for decades. Hence, 3 decades ago the main challenge of surgical treatment of primary cutaneous melanoma was the aspect of optimal resection margin. Recent studies contest the belief about the necessity of wide resection. The aim: our study was conducted to evaluate an influence of resection margin volume on long-term results of treatment of head and neck primary cutaneous melanoma. Materials and methods. 174 patients with head and neck cutaneous melanoma were included in the study (inclusion interval: 1995-2014). In order to establish real resection boundaries we used the predefined index of cutaneous flap contraction (median: 30%). Therefore, for subsequent statistical analysis patients were defined into 3 subgroups: 1) resection margin 1.0 cm. Results. Disease free survival did not correlate with resection margin. It was better (77,3%) with minimal resection margin and the worst with maximal resection margin (38,7%). In other words an increase in resection margin has no influence on long-term results. Conclusions. According to international clinical guidelines resection margin ≥1 сm is considered sufficient for T1-2 and 2 cm - for T3-4 cutaneous melanoma of all localizations. Our retrospective study with regard to the predefined index of cutaneous flap contraction was characterized by resection margin