Bittar Julie M, Bittar Peter G, Wan Marilyn T, Kovell Robert C, Guzzo Thomas J, Shin Thuzar M, Etzkorn Jeremy R, Sobanko Joseph F, Miller Christopher J
Indiana University School of Medicine, Indianapolis, Indiana.
Duke University School of Medicine, Durham, North Carolina.
Dermatol Surg. 2018 Sep;44(9):1159-1169. doi: 10.1097/DSS.0000000000001579.
Few data exist to guide surgical management and counseling about local recurrence after surgery of primary male genital melanoma.
To compile all available data on local recurrence rates after surgery of primary cutaneous melanoma of the penis and scrotum.
A systematic review of PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Excerpta Medica database (EMBASE), and Web of Science identified all surgically treated penile and scrotal melanomas that reported local recurrence status and follow-up time.
One hundred twenty-seven melanomas from 74 manuscripts were included. Eighty-six percent of melanomas were located on the penis, and 14% were located on the scrotum. Average follow-up time was 35.7 months. Scrotal melanomas were predominantly treated with organ-sparing surgeries (16/18, 88.9%), whereas penile melanomas were treated more often with amputation (61/109, 56.0%). Overall, local recurrence rate was 15.7% (20/127). Local recurrence rates for penile cases were 18.8% (9/48) after organ-sparing surgery versus 13.1% (8/61) for amputative surgery. Local recurrence rates were 66.7% (4/6) after positive surgical margins versus 10.2% (5/49) after negative surgical margins.
Local recurrence rates are high after both organ-sparing and amputative surgery of primary cutaneous melanoma of the penis and scrotum. There is a need to standardize reporting for this rare tumor, as more complete data are necessary to develop consensus guidelines for surgical management of male genital melanoma.
