Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

The Role of Wide Excision of Primary Lesion in Cutaneous Malignant Melanoma: A Retrospective Analysis on Its Usefulness in Local and General Control of Disease

Eleonora Nacchiero
* ,
Massimo Giotta
ORCID logo ,
Fabio Robusto
,
Maria Elvira Metta
,
Valentina Ronghi
,
Rossella Elia
,
Paolo Trerotoli
ORCID logo ,
Giuseppe Giudice
Version 1 : Received: 22 January 2024 / Approved: 25 January 2024 / Online: 25 January 2024 (08:39:56 CET)

How to cite: Nacchiero, E.; Giotta, M.; Robusto, F.; Metta, M.E.; Ronghi, V.; Elia, R.; Trerotoli, P.; Giudice, G. The Role of Wide Excision of Primary Lesion in Cutaneous Malignant Melanoma: A Retrospective Analysis on Its Usefulness in Local and General Control of Disease. Preprints 2024, 2024011816. https://doi.org/10.20944/preprints202401.1816.v1 Nacchiero, E.; Giotta, M.; Robusto, F.; Metta, M.E.; Ronghi, V.; Elia, R.; Trerotoli, P.; Giudice, G. The Role of Wide Excision of Primary Lesion in Cutaneous Malignant Melanoma: A Retrospective Analysis on Its Usefulness in Local and General Control of Disease. Preprints 2024, 2024011816. https://doi.org/10.20944/preprints202401.1816.v1

Abstract

Actually wide excision is recommended after the primary excision of any cutaneous melanomas. The definition of the margins of wide excision indicated by the guidelines has remained unchanged over the years, although the reported indications derived from fairly dated studies, in which melanomas tend to be thicker or in advanced stages at diagnosis. These indications may no longer be current; especially in those patients affected by in situ or thin melanoma, exposing patients to a possible overtreatment. A retrospective observational study was conducted in patients who had undergone surgery for melanoma in a single institution. In a univariate model a melanoma-positive wide excision resulted related with a worst progression free survival (PFS); but this association was not confirmed in the multivariable model. Moreover, logistic model were applied to estimate the probability to find a metastasis after wide local excision (WLE) in relation to demographic data of patients and histologic information of the melanoma. Results testified that the Breslow thickness was the only factor associated with the increase of the risk to found metastases in the WLE area. The ROC curve testified that the optimum cut-off value to differentiate patients with respect those without a tumor-positive wide excision, was a Breslow thickness of 2.31mm in women, and 2.4mm in men.

Keywords

Wide excision; malignant melanoma; control of disease; overtreatment; melanoma prognosis

Subject

Medicine and Pharmacology, Surgery

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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