Examining the Influence of Residual Disease in Excision after Diagnosis with Partial Biopsy in Melanoma

Source: American college of Surgeons, May 2022

Ramiscal JAB, Stern SI, Wilson AK, et al. Does Residual Invasive Disease in Wide Local Excision after Diagnosis with Partial Biopsy Technique Influence Survival in Melanoma Matched Pair Analysis of Multicenter Selective Lymphadenectomy Trial I and II. J Am Coll Surg. 2022, in press.

Clinical practice guidelines recommend complete biopsy of melanoma lesions with no residual disease detectable at the biopsy site after wide local excision, but data supporting a survival advantage for this practice are scarce. The authors of this report reviewed data from two large melanoma trials and developed a study cohort of 872 patients to determine whether residual disease discovered after wide local excision adversely affects long-term survival. Principal outcomes included melanoma-specific survival, distant disease-free survival, and disease-free survival.

Residual tumor was discovered on wide local excision of the initial biopsy site in 46% of patients. Matched pair analysis comparing patients with and without residual disease following wide local excision showed no statistically significant difference for any of the survival outcomes.