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Gaceta médica de México

On-line version ISSN 2696-1288Print version ISSN 0016-3813

Abstract

LINO-SILVA, Leonardo S. et al. Recurrence rate and survival implications of surgical margins in patients with acral melanoma. Is a wide margin necessary?. Gac. Méd. Méx [online]. 2023, vol.159, n.1, pp.38-43.  Epub May 02, 2023. ISSN 2696-1288.  https://doi.org/10.24875/gmm.22000192.

Introduction:

Appropriate size of resection margins in acral melanoma is not clearly established.

Objective:

To investigate whether narrow-margin excision is appropriate for thick acral melanoma.

Methods:

Three-hundred and six patients with acral melanoma were examined. Factors associated with recurrence and survival were analyzed according to surgical margin size (1 to 2 cm and > 2 cm).

Results:

Out of 306 patients, 183 were women (59.8%). Median Breslow thickness was 6 mm; 224 cases (73.2%) were ulcerated, 154 patients (50.3%) had clinical stage III disease, while 137 were at stage II (44.8%) and 15 at stage IV (4.9%). All cases had negative margins, with a median of 31.5 mm. A Breslow thickness of 7 mm (p = 0.001) and clinical stage III (p = 0.031) were associated with recurrence; the factors associated with survival were Breslow index (p = 0.047), ulceration (p = 0.003), advanced clinical stage (p < 0.001), and use of adjuvant therapy (p = 0.003).

Conclusion:

A resection margin of 1 to 2 cm did not affect tumor recurrence or survival in patients with acral melanoma.

Keywords : Surgical margin; Acral melanoma; Survival.

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