Disease-specific survival of malignant melanoma after Mohs micrographic surgery is not impacted by initial margins: A systematic review and meta-analysisCapsule Summary
Background: During Mohs surgery for melanoma, evidence has demonstrated that many surgeons opt for smaller initial margins than traditionally recommended (0.5 cm for in situ and 1 cm for invasive). Literature regarding surgical outcomes based on initial margin is sparse. Objective: To determine diff...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | JAAD International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666328723000974 |
| _version_ | 1797669707732484096 |
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| author | Olivia M. Crum, MD Elliott H. Campbell, MD Cynthia J. Chelf, MLS, AHIP Addison M. Demer, MD Jerry D. Brewer, MD, MS |
| author_facet | Olivia M. Crum, MD Elliott H. Campbell, MD Cynthia J. Chelf, MLS, AHIP Addison M. Demer, MD Jerry D. Brewer, MD, MS |
| author_sort | Olivia M. Crum, MD |
| collection | DOAJ |
| description | Background: During Mohs surgery for melanoma, evidence has demonstrated that many surgeons opt for smaller initial margins than traditionally recommended (0.5 cm for in situ and 1 cm for invasive). Literature regarding surgical outcomes based on initial margin is sparse. Objective: To determine differences in disease-specific survival of melanoma after Mohs micrographic surgery for varied initial surgical margins. Methods: A literature search was conducted on February 14, 2022, from MEDLINE via PubMed (1946-present), Embase (1974-present), Central (1991-present), and Scopus (1960-present). The primary outcome was disease-specific mortality. Results: Nineteen studies were included for final analysis. The overall disease-specific mortality rate of melanoma in all included studies was 0.5% (CI, 0.1-0.8; P, .010). Disease-specific mortality for 1 to 5, 5, and 6 to 10 mm categories were 0.4% (CI, 0.0-0.9; P, .074), 0.7% (CI, 0.2-1.3; P, .2-1.3), and 0.4% (CI, –0.9 to 1.8; P, .524), respectively. None of the variances across initial margin categories were statistically significant. Limitations: Early-stage melanomas have low overall mortality rates. In our associated article, initial margins of 5 to 10 mm were shown to have the lowest rates of local recurrence. Conclusions: In this systematic review and meta-analysis, melanoma-specific mortality was not significantly impacted by the initial surgical margin taken during Mohs micrographic surgery. |
| first_indexed | 2024-03-11T20:48:25Z |
| format | Article |
| id | doaj.art-6cb1505328b24fcf9cea9fb80a2db7a4 |
| institution | Directory Open Access Journal |
| issn | 2666-3287 |
| language | English |
| last_indexed | 2024-03-11T20:48:25Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JAAD International |
| spelling | doaj.art-6cb1505328b24fcf9cea9fb80a2db7a42023-10-01T06:03:26ZengElsevierJAAD International2666-32872023-12-0113140149Disease-specific survival of malignant melanoma after Mohs micrographic surgery is not impacted by initial margins: A systematic review and meta-analysisCapsule SummaryOlivia M. Crum, MD0Elliott H. Campbell, MD1Cynthia J. Chelf, MLS, AHIP2Addison M. Demer, MD3Jerry D. Brewer, MD, MS4Department of Dermatology, Mayo Clinic School of Graduate Medical Education, Rochester, MinnesotaDepartment of Dermatology, Mayo Clinic School of Graduate Medical Education, Rochester, MinnesotaMayo Clinic Libraries, Rochester, MinnesotaDivision of Dermatologic Surgery, Department of Dermatology, Mayo Clinic, Rochester, MinnesotaDivision of Dermatologic Surgery, Department of Dermatology, Mayo Clinic, Rochester, Minnesota; Correspondence to: Jerry D. Brewer, MD, MS, Division of Dermatologic Surgery, Department of Dermatology, Mayo Clinic, Rochester, MN 55905.Background: During Mohs surgery for melanoma, evidence has demonstrated that many surgeons opt for smaller initial margins than traditionally recommended (0.5 cm for in situ and 1 cm for invasive). Literature regarding surgical outcomes based on initial margin is sparse. Objective: To determine differences in disease-specific survival of melanoma after Mohs micrographic surgery for varied initial surgical margins. Methods: A literature search was conducted on February 14, 2022, from MEDLINE via PubMed (1946-present), Embase (1974-present), Central (1991-present), and Scopus (1960-present). The primary outcome was disease-specific mortality. Results: Nineteen studies were included for final analysis. The overall disease-specific mortality rate of melanoma in all included studies was 0.5% (CI, 0.1-0.8; P, .010). Disease-specific mortality for 1 to 5, 5, and 6 to 10 mm categories were 0.4% (CI, 0.0-0.9; P, .074), 0.7% (CI, 0.2-1.3; P, .2-1.3), and 0.4% (CI, –0.9 to 1.8; P, .524), respectively. None of the variances across initial margin categories were statistically significant. Limitations: Early-stage melanomas have low overall mortality rates. In our associated article, initial margins of 5 to 10 mm were shown to have the lowest rates of local recurrence. Conclusions: In this systematic review and meta-analysis, melanoma-specific mortality was not significantly impacted by the initial surgical margin taken during Mohs micrographic surgery.http://www.sciencedirect.com/science/article/pii/S2666328723000974disease-specific mortalityinitial marginmelanomaMohs micrographic surgerysurvival |
| spellingShingle | Olivia M. Crum, MD Elliott H. Campbell, MD Cynthia J. Chelf, MLS, AHIP Addison M. Demer, MD Jerry D. Brewer, MD, MS Disease-specific survival of malignant melanoma after Mohs micrographic surgery is not impacted by initial margins: A systematic review and meta-analysisCapsule Summary JAAD International disease-specific mortality initial margin melanoma Mohs micrographic surgery survival |
| title | Disease-specific survival of malignant melanoma after Mohs micrographic surgery is not impacted by initial margins: A systematic review and meta-analysisCapsule Summary |
| title_full | Disease-specific survival of malignant melanoma after Mohs micrographic surgery is not impacted by initial margins: A systematic review and meta-analysisCapsule Summary |
| title_fullStr | Disease-specific survival of malignant melanoma after Mohs micrographic surgery is not impacted by initial margins: A systematic review and meta-analysisCapsule Summary |
| title_full_unstemmed | Disease-specific survival of malignant melanoma after Mohs micrographic surgery is not impacted by initial margins: A systematic review and meta-analysisCapsule Summary |
| title_short | Disease-specific survival of malignant melanoma after Mohs micrographic surgery is not impacted by initial margins: A systematic review and meta-analysisCapsule Summary |
| title_sort | disease specific survival of malignant melanoma after mohs micrographic surgery is not impacted by initial margins a systematic review and meta analysiscapsule summary |
| topic | disease-specific mortality initial margin melanoma Mohs micrographic surgery survival |
| url | http://www.sciencedirect.com/science/article/pii/S2666328723000974 |
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