title: Limited role for histopathological examination of re-excision specimens of completely excised melanomas.
abstract: The Dutch melanoma guideline advises to examine one central block of the re-excision scar in case of a complete primary excision. To increase the evidence for this recommendation, we re-evaluated how often residual melanoma was found in re-excision specimens of a large series of completely excised melanomas. Of 1,209 Dutch melanoma cases, pathology reports of primary excisions were reviewed. Presence of melanoma in the margins was scored. All melanomas with a complete primary excision were included and pathology reports of re-excisions were reviewed. Presence of residual melanoma in the re-excision specimen and the number of blocks were scored. Slides of re-excision specimens containing residual melanoma were reviewed. Eventually, in four out of 812 melanomas (0.5 %) with a complete primary excision, residual melanoma was found in the re-excision specimen. The free margins of the primary melanomas in these cases ranged from 0.5-3.5 mm. In one case, the margin for melanoma in situ was 0.2 mm. In <1 % of initially completely excised melanomas, residual melanoma was found in the re-excision specimen. Histopathological examination of these re-excision specimens may not be cost-efficient. Our findings even imply that a re-excision could safely be omitted in selected cases of completely excised melanomas.
authors.affiliation: Department of Dermatology/370, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands, Anne.deWaal@radboudumc.nl.
authors.forename: A C
authors.initials: AC
authors.lastname: de Waal
authors.forename: R
authors.initials: R
authors.lastname: Vossen
authors.forename: K K H
authors.initials: KK
authors.lastname: Aben
authors.forename: L A L M
authors.initials: LA
authors.lastname: Kiemeney
authors.forename: M M
authors.initials: MM
authors.lastname: van Rossum
authors.forename: W A M
authors.initials: WA
authors.lastname: Blokx
mesh_terms: D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D009426:Netherlands; D012086:Reoperation / Q000191:economics; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery