Results of 3 cm excision margin for melanoma of the scalp.
Local recurrence and survival were evaluated in 19 patients with melanoma of the scalp after conservative local treatment using a standard protocol of 3 cm excision margins and split skin grafting. Sixteen men and three women had a mean age of 46 years. 12 presented with stage I disease, one with stage II, five with stage III, and one with stage IV disease. Nodular melanoma was present in 16 patients. 17 patients had either Clark level IV or V lesions and mean Breslow depth was 3.4 mm (range 0.9-25). Local recurrence occurred in only one patient who had an excision biopsy performed. Six of 12 patients with stage I disease developed regional adenopathy and only 2 are alive after therapeutic block dissection. All patients with stage III and stage IV disease have died. Excision using 3 cm margin is adequate to control local disease. Scalp melanoma is a specific anatomical subsite associated with a high incidence of regional disease and has a poor prognosis. This high risk group of patients may benefit from elective lymph node dissection.
Hudson
D A
DA
Department of Plastic Surgery, University of Cape Town, South Africa.
Krige
J E
JE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000556:secondary / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012535:Scalp; D012878:Skin Neoplasms / Q000601:surgery*