Local melanoma recurrences in the scar after limited surgery for primary tumor

• Published in: World journal of surgery 1995-05, Vol.19 (3), p.346-349
• Main Authors: Drzewiecki, Krzysztof T., Andersson, Anders P.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Cicatrix; Female; Humans; Male; Median Thickness; Melanoma; Melanoma - mortality; Melanoma - surgery; Middle Aged; Neoplasm Recurrence, Local; Parmi; Primary Melanoma; Prognosis; Skin Neoplasms - mortality; Skin Neoplasms - surgery; Superficial Spreading; Survival Rate; Time Factors
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/BF00299155

The clinical and histologic records of 46 consecutive patients were reviewed who during the period 1980–1993 had recurrence from melanoma in the scar after limited surgery for a skin tumor. They constituted about 50% of all patients admitted with local recurrence from melanoma during this period. At reexamination of the primary tumors, 16 were found to be malignant melanomas and 9 were nevi (four atypical and five benign). Twenty‐one specimens were missing, 11 of which had never been sent for histologic examination. The median thickness of nine measurable melanomas was 0.66 mm. The recurrences in scar consisted of 34 primary melanomas: 18 superficial spreading, 4 nodular, 3 lentigo malignant, and 9 unclassified. Twelve tumors were dermal melanoma metastases. The median thickness of the 25 measurable melanomas was 0.78 mm. The 5‐year overall survival was 69%. At the closing date of the study 15 patients had died, 13 of them because of disseminated melanoma. A comparison of the survival curves from this study with those from other series of melanomas with comparable tumor thickness indicates a considerably worse prognosis than is expected with such thin tumors. We believe that the considerable number of local recurrences in the form of a new primary in a scar following limited surgery supports the theory of limited field change around a primary melanoma. Furthermore, limited procedures for primary melanoma, if followed by a recurrence in the scar, worsen the prognosis. Résumé Les dossiers de 46 patients ayant eu une récidive de mélanome au niveau de leur cicatrice après résection limitée entre 1980 et 1993 et en particulier en ce qui conerne les aspects cliniques et histologiques. Ces patients représentaient à peu près 50% de tous les patients admis pour récidive locale pendant cette même ériode de temps. A la revue de la coupe histologique de la tumeur d'origine, il y avait 16 mélanomes malins et 9 nevi (4 atypiques et 5 bénins). De même, il manquaient 21 pièces et parmi celles, 11 n'avaient jamais fait l'objet d'un examen histologique vrai. L'épaisseur moyenne de neuf mélanomes où ce caratère était mesurable était de 0.66 mm. Les récidives au niveau de la cicatrice concernait 34 mélanome primaires, 18 cas d'extensin superficielle, quatre mélanomes nodulaires, trois lentigos malins et neuf non classifiables. L'épaisseur moyenne des 25 tumeurs mesurables était de 0.78 mm. La survie globale à 5 ans était de 69%. A la période de pointage, il y avait 15 décès,