Does morphology have real impact on local and distant recurrences in head and neck cutaneous melanoma?

Introduction. The term “local recurrence” is usually understood as regrowth of a tumor after surgical treatment. The regrowth appears within 3–5 cm from postoperative cicatrix. The causes for such prolonged tumor growth or recurrence of patients with cutaneous melanoma are nonradical surgical treatm...

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Main Authors: A. M. Mudunov, M. B. Pak, L. V. Demidov, K. A. Baryshnikov
Format: Article
Language:Russian
Published: ABV-press 2020-11-01
Series:Опухоли головы и шеи
Subjects:
Online Access:https://ogsh.abvpress.ru/jour/article/view/561
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author A. M. Mudunov
M. B. Pak
L. V. Demidov
K. A. Baryshnikov
author_facet A. M. Mudunov
M. B. Pak
L. V. Demidov
K. A. Baryshnikov
author_sort A. M. Mudunov
collection DOAJ
description Introduction. The term “local recurrence” is usually understood as regrowth of a tumor after surgical treatment. The regrowth appears within 3–5 cm from postoperative cicatrix. The causes for such prolonged tumor growth or recurrence of patients with cutaneous melanoma are nonradical surgical treatment as well as satellite or transit metastases that were not removed in-block with primary tumor. A great number of clinical researches, aimed at examination of melanoma, its patterns, anatomical criteria and features of clinical course, gave an opportunity to separate satellite or transit metastases into an independent group. Such metastases are realized inside or subdermally, up to 2 cm or more than 2 cm from the primary tumor, yet, not reaching the location of the first regional barrier.The aim of the study is to define influence of the main prognostic factors such as tumor thickness according to Breslow, the level of invasion according to Clark and the presence of ulceration on the frequency of local recurrence with cutaneous melanoma of head and neck.Materials and methods. The research involved 174 patients with cutaneous melanoma of head and neck (1995–2014). According to our index of contraction of a skin flap (median 30 %) the true borders of resection were clearly defined within all the patients. Thereby, 3 groups were identified with the following resection margin: 1.0 cm, where followed-up treatment results were analyzed.Results. Progression-free survival didn’t correlate with the size of surgical resection margins. The survival rates were the best with the lowest resection margin under 0.5 cm (77.3 %) and the worst with the highest resection margin more then 1.0 cm (38.7 %). That means that the treatment results don’t depend on the width increase of tumor resection margin.Conclusions. We consider that clear surgical margins for any thickness of cutaneous melanoma of head and neck should be as follows: 4 mm – 0.72 mm (p = 0.016). In our work, the influence of the main prognostic factors, such as tumor thickness according to Breslow, level of invasion according to Clark and ulceration on the frequency of head and neck cutaneous melanoma local recurrences had no impact.
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spelling doaj.art-7596751d7ced4a7d82183fad7392bd402023-03-13T08:43:21ZrusABV-pressОпухоли головы и шеи2222-14682411-46342020-11-01103556410.17650/2222-1468-2020-10-3-55-64405Does morphology have real impact on local and distant recurrences in head and neck cutaneous melanoma?A. M. Mudunov0M. B. Pak1L. V. Demidov2K. A. Baryshnikov3ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииIntroduction. The term “local recurrence” is usually understood as regrowth of a tumor after surgical treatment. The regrowth appears within 3–5 cm from postoperative cicatrix. The causes for such prolonged tumor growth or recurrence of patients with cutaneous melanoma are nonradical surgical treatment as well as satellite or transit metastases that were not removed in-block with primary tumor. A great number of clinical researches, aimed at examination of melanoma, its patterns, anatomical criteria and features of clinical course, gave an opportunity to separate satellite or transit metastases into an independent group. Such metastases are realized inside or subdermally, up to 2 cm or more than 2 cm from the primary tumor, yet, not reaching the location of the first regional barrier.The aim of the study is to define influence of the main prognostic factors such as tumor thickness according to Breslow, the level of invasion according to Clark and the presence of ulceration on the frequency of local recurrence with cutaneous melanoma of head and neck.Materials and methods. The research involved 174 patients with cutaneous melanoma of head and neck (1995–2014). According to our index of contraction of a skin flap (median 30 %) the true borders of resection were clearly defined within all the patients. Thereby, 3 groups were identified with the following resection margin: 1.0 cm, where followed-up treatment results were analyzed.Results. Progression-free survival didn’t correlate with the size of surgical resection margins. The survival rates were the best with the lowest resection margin under 0.5 cm (77.3 %) and the worst with the highest resection margin more then 1.0 cm (38.7 %). That means that the treatment results don’t depend on the width increase of tumor resection margin.Conclusions. We consider that clear surgical margins for any thickness of cutaneous melanoma of head and neck should be as follows: 4 mm – 0.72 mm (p = 0.016). In our work, the influence of the main prognostic factors, such as tumor thickness according to Breslow, level of invasion according to Clark and ulceration on the frequency of head and neck cutaneous melanoma local recurrences had no impact.https://ogsh.abvpress.ru/jour/article/view/561меланома кожиголова и шеяместный рецидивкрай резекциивыживаемость без прогрессирования
spellingShingle A. M. Mudunov
M. B. Pak
L. V. Demidov
K. A. Baryshnikov
Does morphology have real impact on local and distant recurrences in head and neck cutaneous melanoma?
Опухоли головы и шеи
меланома кожи
голова и шея
местный рецидив
край резекции
выживаемость без прогрессирования
title Does morphology have real impact on local and distant recurrences in head and neck cutaneous melanoma?
title_full Does morphology have real impact on local and distant recurrences in head and neck cutaneous melanoma?
title_fullStr Does morphology have real impact on local and distant recurrences in head and neck cutaneous melanoma?
title_full_unstemmed Does morphology have real impact on local and distant recurrences in head and neck cutaneous melanoma?
title_short Does morphology have real impact on local and distant recurrences in head and neck cutaneous melanoma?
title_sort does morphology have real impact on local and distant recurrences in head and neck cutaneous melanoma
topic меланома кожи
голова и шея
местный рецидив
край резекции
выживаемость без прогрессирования
url https://ogsh.abvpress.ru/jour/article/view/561
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AT mbpak doesmorphologyhaverealimpactonlocalanddistantrecurrencesinheadandneckcutaneousmelanoma
AT lvdemidov doesmorphologyhaverealimpactonlocalanddistantrecurrencesinheadandneckcutaneousmelanoma
AT kabaryshnikov doesmorphologyhaverealimpactonlocalanddistantrecurrencesinheadandneckcutaneousmelanoma