title: Number of excisions required to obtain clear surgical margins and prognostic value of AJCC T category for patients with eyelid melanoma.
abstract: OBJECTIVE
  To determine the number of excisions needed to achieve clear margins and the prognostic value of the 7th edition of American Joint Committee on Cancer (AJCC) classification for eyelid melanoma.
  
  
  METHODS
  Retrospective chart review of consecutive patients treated for eyelid melanoma from January 2006 through May 2013 by the senior author at a tertiary care cancer centre.
  
  
  RESULTS
  Of the 64 patients (25 men and 39 women), clear surgical margins were achieved with a single excision in 38 patients (62%), 2 excisions in 21 patients (34%), and 3 excisions in 2 patients (3%). Need for repeat excision was not correlated with the size of the surgical margin (p=0.14) or AJCC TNM classification (p=0.15). Nodal disease at presentation was significantly associated with T category greater than T2b (p=0.0026) and shorter time to disease progression (p=0.007). Patients followed for a minimum of 1 year with T category greater than T2b had a significantly higher risk of nodal or distant metastasis (p=0.0061).
  
  
  CONCLUSIONS
  More than a third of patients with eyelid melanoma required more than 1 excision to achieve clear margins, supporting delayed reconstruction for eyelid melanoma. Nodal metastasis at presentation was significantly correlated with AJCC T category and time to progression.
authors: Orbital Oncology & Ophthalmic Plastic Surgery Program, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Vivian T
authors: VT
authors: Yin
authors: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Carla L
authors: CL
authors: Warneke
authors: Orbital Oncology & Ophthalmic Plastic Surgery Program, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA Department of Ophthalmology and Visual Science, The University of Texas Medical School, Houston, Texas, USA.
authors: Helen A
authors: HA
authors: Merritt
authors: Orbital Oncology & Ophthalmic Plastic Surgery Program, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Bita
authors: B
authors: Esmaeli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005142:Eyelid Neoplasms / Q000145:classification / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008495:Medical Oncology / Q000145:classification / Q000458:organization & administration; D008545:Melanoma / Q000145:classification / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D013508:Ophthalmologic Surgical Procedures; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000145:classification / Q000175:diagnosis / Q000601:surgery*; D012955:Societies, Medical / Q000458:organization & administration; D014481:United States; D055815:Young Adult
keywords: AJCC; melanoma