Comparing 2 cm vs. 1 cm surgical margins in acral melanoma of the sole with Breslow thickness greater than 2 mm: A multicenter retrospective study of 336 Japanese patients

被引：0

作者：

Koizumi, Shigeru ^{[1
,2
]}

Yamazaki, Naoya ^{[3
]}

Ichigozaki, Yuki ^{[4
]}

Kitagawa, Hiroshi ^{[5
]}

Kiniwa, Yukiko ^{[6
]}

Sato, Sayuri ^{[7
]}

Takai, Toshihiro ^{[8
]}

Doi, Reiichi ^{[9
]}

Ito, Takamichi ^{[10
]}

Yasuda, Masahito ^{[11
]}

Kuwatsuka, Yutaka ^{[12
]}

Maekawa, Takeo ^{[13
,14
]}

Asai, Jun ^{[15
]}

Miyagawa, Takuya ^{[16
]}

Matsushita, Shigeto ^{[17
]}

Funakoshi, Takeru ^{[18
]}

Yamamoto, Yosuke ^{[2
]}

Inozume, Takashi ^{[2
]}

Kishi, Akiko ^{[19
]}

Takenouchi, Tatsuya ^{[20
]}

Kokubu, Hiraku ^{[21
]}

Ito, Shusaku ^{[22
]}

Nakamura, Yasuhiro ^{[1
]}

机构：

[1] Saitama Med Univ, Int Med Ctr, Dept Skin Oncol Dermatol, Saitama, Japan

[2] Chiba Univ, Dept Dermatol, Chiba, Japan

[3] Natl Canc Ctr, Dept Dermatol Oncol, Tokyo, Japan

[4] Kumamoto Univ, Fac Life Sci, Dept Dermatol & Plast Surg, Kumamoto, Japan

[5] Mie Univ, Dept Dermatol, Tsu, Mie, Japan

[6] Shinshu Univ, Dept Dermatol, Matsumoto, Japan

[7] Sapporo Med Univ, Sch Med, Dept Dermatol, Sapporo, Japan

[8] Hyogo Canc Ctr, Dept Dermatol, Akashi, Japan

[9] Kurume Univ, Sch Med, Dept Dermatol, Kurume, Japan

[10] Kyushu Univ, Grad Sch Med Sci, Dept Dermatol, Fukuoka, Japan

[11] Gunma Univ, Dept Dermatol, Gunma, Japan

[12] Nagasaki Univ Hosp, Dept Dermatol & Allergol, Nagasaki, Japan

[13] Jichi Med Univ, Dept Dermatol, Shimotsuke, Tochigi, Japan

[14] Jichi Med Univ, Saitama Med Ctr, Dept Dermatol, Saitama, Japan

[15] Kyoto Prefectural Univ Med, Dept Dermatol, Kyoto, Japan

[16] Univ Tokyo, Dept Dermatol, Dept Dermatol, Tokyo, Japan

[17] NHO Kagoshima Med Ctr, Dept Dermatooncol, Kagoshima, Japan

[18] Keio Univ, Sch Med, Dept Dermatol, Tokyo, Japan

[19] Toranomon Gen Hosp, Dept Dermatol, Tokyo, Japan

[20] Niigata Canc Ctr Hosp, Dept Dermatol, Niigata, Japan

[21] Shiga Univ Med Sci, Dept Dermatol, Otsu, Japan

[22] Hitachi Gen Hosp, Dept Dermatol, Hitachi, Japan

来源：

EJSO | 2025年 / 51卷 / 09期

关键词：

acral melanoma; Cutaneous melanoma; Breslow thickness; Surgical margin; Wide local excision; EXCISION MARGINS; THERAPY;

D O I：

10.1016/j.ejso.2025.110264

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Introduction: Multiple randomized trials comparing wide local excision (WLE) with different peripheral margins have established recommended peripheral margins according to Breslow thickness (BT) in the National Comprehensive Cancer Network (NCCN) Guidelines. However, these clinical trials included only a small number of patients with acral melanoma (AM). Therefore, we aimed to compare the prognosis of different WLE peripheral margin cohorts with invasive sole AM. Materials and methods: We conducted a multi-institutional retrospective study of patients with sole AM and a BT greater than 2 mm. Survival outcomes were compared between two groups: those excised with a peripheral margin of 2 cm, as recommended by the NCCN Guidelines, and those excised with a peripheral margin of 1 cm. Results: This study included 336 patients (2 cm margin: n = 226; 1 cm margin, n = 110) with a median follow-up period of 43.1 months. In multivariate analyses, a peripheral margin of 1 cm did not negatively affect survival (local recurrence-free survival [LRFS]: hazard ratio [HR] 1.19, P = 0.38; disease-free survival [DFS]: HR 1.05, P= 0.75). Survival after propensity score matching showed no significant differences between the matched groups (each group: n = 103; 5-year LRFS: 70.6 % vs. 59.3 %, P = 0.13; 5-year DFS: 47.4 % vs. 54.0 %, P = 0.63). Conclusion: A peripheral margin of 1 cm did not negatively influence the prognosis of patients with a sole AM and a BT greater than 2 mm. Narrower surgical margins may be acceptable to minimize morbidity without compromising survival.

引用

页数：7

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