Weinig prognostische betekenis van niet-radicale melanoomexcisie en van melanoomcellen in het re-excisiepreparaat voor totale en ziektevrije overleving van melanoompatiënten

Objective

To determine in patients with skin melanoma whether disease-free and overall survival are associated with the tumour excision type and the presence of residual tumour cells in the re-excision specimen.

Design

Prospective and descriptive.

Method

In the period August 1993-August 2004, 471 patients were diagnosed with stage I/II skin melanoma after partial or non-partial removal of a pigmented skin lesion, followed by re-excision and a sentinel node biopsy at Amsterdam Free University Medical Centre, the Netherlands. All patients were followed prospectively with a mean follow-up of > 5 years. Patients were divided into two groups according to (a) the type of primary excision (radical excision, narrow/radical excision, non-radical excision biopsy and incisional biopsy) and (b) the presence or absence of residual tumour cells in their re-excision specimen. Survival analysis was done using Cox proportional hazard model adjusted for the 8 known most important determinants of melanoma.

Results

Of the 471 patients, the primary excision was radical in 279 patients and narrow/radical in 109 patients; 52 patients underwent a non-radical excision and 31 patients an incisional biopsy. Re-excision was carried out in 441 patients and in 41 of them residual tumour cells were present in the re-excision specimen. Neither the diagnostic biopsy type nor the presence of tumour cells in the re-excision specimen were connected with disease-free or overall survival in the melanoma patients.

Conclusion

Non-radical diagnostic biopsies were not negatively associated with overall and disease-free survival in melanoma patients.

Ned Tijdschr Geneeskd. 2008;152:2288-93