Excision of fascia in melanoma thicker than 2 mm: no evidence for improved clinical outcome.

Hunger, R E; Seyed Jafari, S M; Angermeier, S; Shafighi, Maziar (2014). Excision of fascia in melanoma thicker than 2 mm: no evidence for improved clinical outcome. British journal of dermatology, 171(6), pp. 1391-1396. Wiley-Blackwell 10.1111/bjd.13478

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BACKGROUND Lack of evidence-based data causes significant variation among surgeons concerning the depth of wide excision for primary cutaneous melanomas. OBJECTIVES To evaluate the clinical effect of excision of the deep fascia in melanomas thicker than 2 mm on patient outcome. METHODS We performed a retrospective cohort review (1996-2012) of patients with melanomas thicker than 2 mm. Included patients underwent excision with a 1-cm margin. Data collected included the patients' sex, age, tumour location, tumour type, Breslow depth and presence of ulceration. Local recurrences, locoregional and distant metastases, and disease-free and overall survival were compared between the fascia-excised and the fascia-preserved groups. RESULTS Out of 2182 patients with malignant melanomas, 213 melanomas thicker than 2 mm, with a median follow-up of 1547 days, were included. The mean age of the patients was 62·6 years and the mean Breslow depth was 4·2 mm. Analysis of data for death attributable to melanoma (P = 0·72), local recurrence (P = 0·71), and locoregional (P = 0·87) and distant metastases (P = 0·34) were not significantly different between the study groups. Furthermore, Kaplan-Meier and Cox regression analysis of both groups showed no evidence of significant difference regarding disease-free [P = 0·35; hazard ratio (HR) 1·25; 95% confidence interval (CI) 0·79-1·97] and overall survival (P = 0·63; HR 1·18; 95% CI 0·61-2·27). CONCLUSIONS We believe that excision of the deep fascia does not improve the outcome of melanomas thicker than 2 mm.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Plastic, Reconstructive and Aesthetic Surgery
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Plastische Chirurgie

UniBE Contributor:

Shafighi, Maziar

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0007-0963

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Jörg Arnoldi

Date Deposited:

26 Jan 2015 11:39

Last Modified:

06 Nov 2015 10:41

Publisher DOI:

10.1111/bjd.13478

PubMed ID:

25392906

BORIS DOI:

10.7892/boris.61991

URI:

https://boris.unibe.ch/id/eprint/61991

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