[Low prognostic importance of non-radical melanoma excision and the presence of melanoma cells in the re-excision specimen to overall and disease-free survival of melanoma patients].
OBJECTIVE
To determine in patients with skin melanoma whether disease-free and overall survival are associated with the tumour excision type and the presence of residual tumour cells in the re-excision specimen.


METHODS
Prospective and descriptive.


METHODS
In the period August 1993-August 2004, 471 patients were diagnosed with stage I/II skin melanoma after partial or non-partial removal of a pigmented skin lesion, followed by re-excision and a sentinel node biopsy at Amsterdam Free University Medical Centre, the Netherlands. All patients were followed prospectively with a mean follow-up of > 5 years. Patients were divided into two groups according to (a) the type of primary excision (radical excision, narrow/radical excision, non-radical excision biopsy and incisional biopsy) and (b) the presence or absence of residual tumour cells in their re-excision specimen. Survival analysis was done using Cox proportional hazard model adjusted for the 8 known most important determinants of melanoma.


RESULTS
Of the 471 patients, the primary excision was radical in 279 patients and narrow/radical in 109 patients; 52 patients underwent a nonradical excision and 31 patients an incisional biopsy. Re-excision was carried out in 441 patients and in 41 of them residual tumour cells were present in the re-excision specimen. Neither the diagnostic biopsy type nor the presence oftumour cells in the re-excision specimen were connected with disease-free or overall survival in the melanoma patients.


CONCLUSIONS
Non-radical diagnostic biopsies were not negatively associated with overall and disease-free survival in melanoma patients.
Molenkamp
B G
BG
VU Medisch Centrum, afd. Chirurgische Oncologie, Postbus 7057, 1007 MB Amsterdam.
Sluijter
B J R
BJ
Oosterhof
B
B
Meijer
S
S
Van Leeuwen
P A M
PA
D001706:Biopsy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012086:Reoperation; D012878:Skin Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D015996:Survival Rate; D013997:Time Factors