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Head/Neck Melanomas Have High Local Recurrence Risk

J Am Acad Dermatol; ePub 2018 Nov 17; Fix, et al

Melanomas of the head and neck have high local recurrence risk features and require tissue rearranging reconstruction more frequently than keratinocyte carcinomas (KCs), according to a recent study. Researchers conducted a retrospective cohort study of KC vs melanoma treated at the Hospital of the University of Pennsylvania with Mohs micrographic surgery (MMS). They found:

  • 12,189 KCs (8,743 basal cell carcinoma [BCC], 3,343 squamous cell carcinoma [SCC] and 1,475 melanomas [1,065 melanomas in situ, 410 invasive melanomas]) were identified from a prospectively updated MMS database.
  • Compared to KCs, melanomas were significantly more likely to have high local recurrence risk features, including larger preoperative size (2.10 cm vs 1.30 cm), recurrent status (5.08% vs 3.91%), and subclinical spread (31.73% vs 26.52%).
  • Tissue rearranging reconstruction was significantly more common for melanoma vs KCs (44.68% vs 33.02%; OR 1.98).

Citation:

Fix W, Etzkorn JR, Shin TM, et al. Melanomas of the head and neck have high local recurrence risk features and require tissue rearranging reconstruction more commonly than BCC and SCC: A comparison of indications for microscopic margin control prior to reconstruction in 13,664 tumors. [Published online ahead of print November 17, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.11.020.