title: Recurrence rate of lentigo maligna after micrographically controlled staged surgical excision.
abstract: BACKGROUND
  Lentigo maligna is a slowly growing melanoma in situ. Current guidelines advise wide local excision with a margin of 5 mm as the treatment of first choice, which has recurrence rates ranging from 6% to 20%.
  
  
  OBJECTIVE
  To determine retrospectively the recurrence rate of lentigo maligna after staged surgical excision.
  
  
  METHODS
  Records of all patients with lentigo maligna treated with our method of staged surgical excision between 2002 and 2011 were retrieved. To identify recurrences we used the computer program Sympathy, which is linked to PALGA, a nationwide network and registry of histo- and cytopathology in the Netherlands.
  
  
  RESULTS
  We identified 100 patients, who were treated with staged surgical excision with 100% immunohistopathological control of lateral margins. Digital pictures were used to facilitate orientation during the several stages of surgery. After a mean follow-up of 60 months, four patients had a recurrence, after 37, 58, 74 and 77 months of follow-up.
  
  
  CONCLUSIONS
  Staged surgical excision is superior in clearance and recurrence rates to wide local excision for lentigo maligna and should be considered as the treatment of first choice in national and international guidelines.
authors.affiliation: Department of Dermatology, University Medical Center Groningen, Groningen, the Netherlands.|Department of Dermatology, Erasmus University Medical Center, 3000, CA, Rotterdam, the Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: de Vries
authors.affiliation: Department of Dermatology, Erasmus University Medical Center, 3000, CA, Rotterdam, the Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Greveling
authors.affiliation: Department of Dermatology, Erasmus University Medical Center, 3000, CA, Rotterdam, the Netherlands.
authors.forename: L M
authors.initials: LM
authors.lastname: Prens
authors.affiliation: Department of Dermatology, Maasstad Ziekenhuis, Rotterdam, the Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Munte
authors.affiliation: Department of Pathology, Erasmus University Medical Center, 3000, CA, Rotterdam, the Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Koljenović
authors.affiliation: Department of Dermatology, Erasmus University Medical Center, 3000, CA, Rotterdam, the Netherlands.
authors.forename: M B A
authors.initials: MB
authors.lastname: van Doorn
authors.affiliation: Department of Dermatology, Erasmus University Medical Center, 3000, CA, Rotterdam, the Netherlands.
authors.forename: E P
authors.initials: EP
authors.lastname: Prens
mesh_terms: D005153:Facial Neoplasms / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000601:surgery*; D008297:Male; D000072662:Margins of Excision; D015580:Mohs Surgery / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012535:Scalp / Q000601:surgery*; D012878:Skin Neoplasms / Q000601:surgery*