التفاصيل البيبلوغرافية
| العنوان: |
A cohort analysis of surgically treated primary head and neck lentigo maligna (melanoma): Prognostic value of melanoma subtype and new insights in the clinical value of guideline adherence. |
| المؤلفون: |
Elshot, Yannick S., Zupan-Kajcovski, Biljana, Ouwerkerk, Wouter, Klop, W. Martin C., Lohuis, Peter J.F.M., Bol, Mijke, Crijns, Marianne B., Bekkenk, Marcel.W., de Rie, Menno A., Balm, Alfons J.M. |
| المصدر: |
European Journal of Surgical Oncology; Apr2023, Vol. 49 Issue 4, p818-824, 7p |
| مصطلحات موضوعية: |
PROGNOSIS, LENTIGO, HEAD & neck cancer, COHORT analysis, MELANOMA, SURVIVAL rate |
| مستخلص: |
Knowledge about lentigo maligna (melanoma) (LM/LMM) and its associated prognostic clinicopathological characteristics are limited compared to that of non-LM/LMM subtypes. The current study aimed to determine the clinical relevance of the LM/LMM subtype and its influence on recurrence and survival outcomes. All consecutive cases of primary cutaneous head and neck LM/LMM treated by wide local excision over a ten-year period were retrospectively reviewed and compared to non-LM/LMM. Clinical outcome and prognostic factors were assessed by cumulative incidence and competing risk analyses. A total of 345 patients were identified. Specific clinicopathological characteristics such as lower median Breslow thickness (1.6 mm versus 2.1 mm; P = 0.013), association with diagnostic sampling errors (17.3% versus 5.2%; P = 0.01), and increased risk of local recurrences due to incomplete resection (18.7% versus 2.3%; P < 0.001), were significantly associated with LM/LMM. Guideline adherence was similar between the two study groups. The positive nodal status at baseline for LMM was low compared to non-LM/LMM (4.2% vs 17.9%; P = 0.037). The LMM subtype, facial localization, and reduced surgical margins (i.e., guideline non-adherence) were not shown to be independent prognostic factors for disease-free, melanoma-specific, or overall survival after correction for competing risks such as patient age and Breslow thickness. The LMM subtype was not shown to be prognostically different from non-LM/LMM when corrected for other variables of influence such as patient age and Breslow thickness. Reduced resection margins did not seem to affect disease-free, and melanoma-specific survival and warrant LM/LMM-specific guidelines. Further research is needed to evaluate the value of SLNB in LMM patients. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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