Lee Kyeong-Tae, Kim Eun-Ji, Lee Dong-Youn, Kim Jung-Han, Jang Kee-Taek, Mun Goo-Hyun
Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
J Surg Oncol. 2016 Dec;114(8):933-939. doi: 10.1002/jso.24442. Epub 2016 Sep 19.
This study aimed to evaluate treatment outcomes of acral melanoma (AM) based on the excision margin.
A retrospective cohort study was conducted for patients with primary AM, analyzing recurrence rates, local and in-transit recurrence-free survival (LITRFS), disease-free survival (DFS), and melanoma-specific survival (MSS).
Data from 129 patients of AM were analyzed. In 53 patients with thin AM (thickness ≤1 mm), neither recurrence nor mortality occurred regardless of whether the excision margin was >1 cm or not. Seventy-six patients had thick AM (thickness >1 mm), including 36 treated with a <2 cm excision margin and 40 with a 2 cm margin. Multivariate analyses revealed that a 2 cm margin was associated with a reduced rate of local recurrence (HR, 0.120; P-value = 0.023) and LITR (HR, 0.187; P-value = 0.013) compared with a <2 cm margin. DFS and MSS did not differ between the two groups.
Thin AM were successfully treated with a 1 cm excision margin. For thick AM, a 2 cm excision margin provided improved local control, compared with a <2 cm margin; however, this benefit did not translate into a survival gain. J. Surg. Oncol. 2016;114:933-939. © 2016 Wiley Periodicals, Inc.
本研究旨在基于切缘评估肢端黑色素瘤（AM）的治疗效果。
对原发性AM患者进行回顾性队列研究，分析复发率、局部及区域无复发生存率（LITRFS）、无病生存率（DFS）和黑色素瘤特异性生存率（MSS）。
分析了129例AM患者的数据。在53例薄型AM（厚度≤1mm）患者中，无论切缘是否>1cm，均未发生复发或死亡。76例患者为厚型AM（厚度>1mm），其中36例切缘<2cm，40例切缘为2cm。多因素分析显示，与切缘<2cm相比，2cm切缘与局部复发率降低（HR，0.120；P值=0.023）和区域复发（HR，0.187；P值=0.013）相关。两组间DFS和MSS无差异。
薄型AM采用1cm切缘可成功治疗。对于厚型AM，与切缘<2cm相比，2cm切缘可改善局部控制；然而，这种益处并未转化为生存获益。《外科肿瘤学杂志》2016年；114：933 - 939。©2016威利期刊公司
