Lentigo maligna melanoma mapping using reflectance confocal microscopy correlates with staged excision: A prospective study - 11/01/23
Abstract |
Background |
Lentigo maligna/lentigo maligna melanoma (LM/LMM) can present with subclinical extension that may be difficult to define preoperatively and lead to incomplete excision and potential recurrence. Preliminarily studies have used reflectance confocal microscopy (RCM) to assess LM/LMM margins.
Objective |
To evaluate the correlation of LM/LMM subclinical extension defined by RCM compared with the gold standard histopathology.
Methods |
Prospective study of LM/LMM patients referred for dermatologic surgery. RCM was performed at the clinically defined initial surgical margin followed by margin-controlled staged excision with paraffin-embedded tissue, and histopathology was correlated with RCM results.
Results |
Seventy-two patients were included. Mean age was 66.8 years (standard deviation, 11.1; range, 38-89); 69.4% were men. Seventy of 72 lesions (97.2%) were located on the head and neck with mean largest clinical diameter of 1.3 cm (range, 0.3-5). Diagnostic accuracy for detection of residual melanoma in the tumor debulk (after biopsy) had a sensitivity of 96.7% and a specificity of 66.7% when compared with histopathology. RCM margin assessment revealed an overall agreement with final histopathology of 85.9% (κ = 0.71; P < .001).
Limitations |
No RCM imaging beyond initial planned margins was performed.
Conclusion |
RCM showed moderate to excellent overall agreement between RCM imaging of LM/LMM and histopathology of staged excision margins.
Le texte complet de cet article est disponible en PDF.Key words : lentigo maligna, margins, melanoma, Mohs surgery, reflectance confocal microscopy, staged excision, surgery
Abbreviations used : CI, LM/LMM, RCM, SD
Plan
| Funding sources: Supported in part by the National Institutes of Health/National Cancer Institute Cancer Center Support Grant P30 CA008748. The funder played no role in any aspect of the study. |
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| Conflicts of interest: Dr Rossi has received grant funding from The Skin Cancer Foundation and the A.Ward Ford Memorial Grant for research related to this work and has served on an advisory board, as a consultant, or given educational presentations for Allergan, Inc, Galderma Inc, Evolus Inc, Elekta, Biofrontera, Quantia, Merz Inc, Dynamed, Skinuvia, Perf-Action, and LAM therapeutics. Dr Nehal has received royalties from publishing companies for books and book chapters. All other authors have no conflicts of interest to declare. |
Vol 88 - N° 2
P. 371-379 - février 2023 Retour au numéro
Article précédent
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