Abstract | BACKGROUND:
Mohs micrographic surgery (MMS) represents a promising option for treatment of melanoma in situ (MIS). However, interpretation of melanocytic lesions by fresh frozen sections may be difficult. OBJECTIVE: The objective of this study was to determine if margins called clear by MMS were clear by subsequent paraffin-embedded sections and to compare cure rate with available data for MMS and standard excision. MATERIALS AND METHODS: A total of 167 patients with MIS, including 116 patients with MIS in sun-exposed skin of lentigo maligna (LM) type, were treated by MMS with subsequent evaluation of the final margin with paraffin-embedded sections that were cut en face, over a period of 12 years. A total of 143 patients were available for follow-up from 6 months to 12 years (mean, 50 months; median 48 months; 594.5 patient-years), and 109 patients were available for follow-up from 2 to 12 years (mean, 63 months; median, 60 months; 569 patient-years). RESULTS: The clearance rate by MMS technique using frozen sections was 94.1% for MIS non-LM type, 95.7% for MIS LM type, and 95.1% for both. The cure rate was 97.8% for MIS non-LM type, 99.0% for MIS LM type, and 98.6% for both for mean follow-up of 50 months and 97.4% for MIS non-LM type, 98.6% for MIS LM type, and 98.2% for both for mean follow-up of 63 months. CONCLUSION: MMS is a viable option for treatment of MIS that may increase cure rate and reduce the size of the defect especially in cosmetically and functionally sensitive areas.
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Authors | Natalie I Bene, Chris Healy, Brett M Coldiron |
Journal | Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
(Dermatol Surg)
Vol. 34
Issue 5
Pg. 660-4
(May 2008)
ISSN: 1524-4725 [Electronic] United States |
PMID | 18261099
(Publication Type: Journal Article)
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Topics |
- Carcinoma in Situ
(pathology, surgery)
- Facial Neoplasms
(pathology, surgery)
- Frozen Sections
- Humans
- Hutchinson's Melanotic Freckle
(pathology, surgery)
- Melanocytes
(pathology)
- Melanoma
(pathology, surgery)
- Neoplasm Recurrence, Local
(epidemiology)
- Paraffin Embedding
- Skin Neoplasms
(pathology, surgery)
- Treatment Outcome
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