Connolly Karen L, Hibler Brian P, Lee Erica H, Rossi Anthony M, Busam Klaus J, Nehal Kishwer S
*Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York; †Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Dermatol Surg. 2017 Jun;43(6):792-797. doi: 10.1097/DSS.0000000000001118.
Various studies have reported local recurrence (LR) rates after surgical treatment of lentigo maligna (LM) and lentigo maligna melanoma (LMM). However, the time to LR of LM/LMM is not currently known, as few studies report time to LR and have long-term follow-up.
To define time to LR in LM/LMM after surgical treatment, and to describe features of observed LR.
Retrospective single-center study of consecutive patients presenting with locally recurrent LM/LMM.
Six hundred forty-nine cases of LM/LMM were reviewed; 29 (21 LM, and 8 LMM) of 41 locally recurrent cases had original histology reports and were included. The mean time to LR was 57.5 months (range 7-194). For cases presenting as primary LM, LR was also in situ in 14/21 (67%) of cases. Seven of 21 LM recurred as LMM. Of the 8 primary LMM, 3/8 (37.5%) presented with subsequent LMM and all were slightly deeper on re-excision.
The mean time to LR of LM/LMM is at least 57.5 months, underscoring the importance of long-term follow-up. Seven of 21 LM recurred as invasive disease, but the lack of development of LMM from LM in most recurrent cases confirms LM is slowly progressive.
多项研究报告了恶性雀斑样痣(LM)和恶性雀斑样痣黑色素瘤(LMM)手术治疗后的局部复发(LR)率。然而,目前尚不清楚LM/LMM的LR时间,因为很少有研究报告LR时间且缺乏长期随访。
确定手术治疗后LM/LMM的LR时间,并描述观察到的LR特征。
对连续出现局部复发的LM/LMM患者进行回顾性单中心研究。
回顾了649例LM/LMM病例;41例局部复发病例中有29例(21例LM和8例LMM)有原始组织学报告并被纳入研究。LR的平均时间为57.5个月(范围7 - 194个月)。对于以原发性LM表现的病例,14/21(67%)的LR也是原位的。21例LM中有7例复发为LMM。在8例原发性LMM中,3/8(37.5%)随后出现LMM,再次切除时均略深。
LM/LMM的LR平均时间至少为57.5个月,强调了长期随访的重要性。21例LM中有7例复发为浸润性疾病,但大多数复发病例中LM未发展为LMM,这证实LM进展缓慢。