Foxton Glen C, Elliott Timothy G, Litterick Kelly A
South Perth Specialist Skin Cancer Centre, Perth, Western Australia, Australia.
Australas J Dermatol. 2019 Feb;60(1):33-37. doi: 10.1111/ajd.12845. Epub 2018 Jun 22.
BACKGROUND/OBJECTIVES: There is a paucity of Australian data on the use of Mohs micrographic surgery for treating melanoma in situ and lentigo maligna. We share an Australian centre's experience with the technique.
A total of 62 patients with 62 lesions of melanoma in situ and lentigo maligna referred for treatment between 2015 and 2017 comprised the study group. All melanomas were excised with Mohs micrographic surgery utilising melanoma-associated antigen recognised by T-cells (MART-1) immunostaining.
Follow up ranged from 3 to 30 months with no reported recurrences or melanoma-related deaths. 94% (58/62) of lesions were primary melanomas and 6% were locally recurrent. 89% of lesions involved head and neck sites with 11% involving trunk or limbs. In total 55% (12/62) of lesions were cleared with 3-mm clinical margins, 68% with 6 mm, 92% with 9 mm and 100% with 12-mm. The mean clinical excision margin was 6.7 mm. All lesions with a tumour diameter greater than 2.2 cm required a 9-mm clinical margin or greater for excision. The mean clinical excision margin for recurrent tumours was 9 mm.
We provide the first Australian data on the use of Mohs micrographic surgery for melanoma.
背景/目的：澳大利亚关于使用莫氏显微描记手术治疗原位黑色素瘤和恶性雀斑样痣的数据匮乏。我们分享澳大利亚一家中心在该技术方面的经验。
2015年至2017年间转诊接受治疗的62例原位黑色素瘤和恶性雀斑样痣患者共62处病灶组成研究组。所有黑色素瘤均采用莫氏显微描记手术切除，并利用T细胞识别的黑色素瘤相关抗原（MART-1）进行免疫染色。
随访时间为3至30个月，无复发病例或黑色素瘤相关死亡报告。94%（58/62）的病灶为原发性黑色素瘤，6%为局部复发性。89%的病灶累及头颈部，11%累及躯干或四肢。总共55%（12/62）的病灶在临床切缘为3毫米时清除，68%在6毫米时清除，92%在9毫米时清除，100%在12毫米时清除。平均临床切除切缘为6.7毫米。所有肿瘤直径大于2.2厘米的病灶切除时需要9毫米或更大的临床切缘。复发性肿瘤的平均临床切除切缘为9毫米。
我们提供了澳大利亚关于使用莫氏显微描记手术治疗黑色素瘤的首批数据。
