The following is a summary of “Histologic margin status is a predictor of relapse in lentigo maligna melanoma,” published in the November 2023 issue of Dermatology by Hoang, et al.
In the realm of lentigo maligna melanomas, existing literature predominantly relies on clinical rather than histologic assessments of surgical margins. For a study, researchers sought to discern whether histologic margin status autonomously predicted progression. Analyzing data from 268 invasive lentigo maligna melanoma cases diagnosed between 1990 and 2019, they employed statistical methods, including the Cox proportional hazards model and Boruta method.
Most lesions (75%) were situated on the head and neck. Patient follow-up spanned 0 to 31.8 years (median, 10.2 years), with local recurrence observed within 0 to 20 years (median, 3 years). Progression occurred in 54 cases (20.1% of 268 patients). Among these, 36 experienced local recurrence (13.4%), 7 had both local recurrence and subsequent metastasis (2.6%), and 11 exhibited only metastasis (4.1%). Histologic margin status (positive and close/<3 mm) and tumor location on the head and neck significantly correlated with compromised progression-free survival.
Acknowledging the study’s limitations as a single-institution, retrospective analysis, the findings underscored histologic margin status as the foremost predictor of lentigo maligna melanoma progression. Notably, patients with positive or close/<3 mm histologic margins should consider re-excision due to the heightened risk of relapse.
Source: jaad.org/article/S0190-9622(23)01349-X/fulltext
