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Slow Mohs Micrographic Surgery for Acral Melanoma Treatment in Korean Patients

 Jimyung Seo  ;  Yeongjoo Oh  ;  Sang Kyum Kim  ;  Mi Ryung Roh  ;  Kee Yang Chung 
 DERMATOLOGIC SURGERY, Vol.47(2) : e42-e46, 2021-02 
Journal Title
Issue Date
Adult ; Aged ; Disease-Free Survival ; Female ; Follow-Up Studies ; Foot ; Hand ; Humans ; Male ; Margins of Excision ; Melanoma / diagnosis ; Melanoma / mortality ; Melanoma / pathology ; Melanoma / surgery* ; Middle Aged ; Mohs Surgery / methods* ; Neoplasm Recurrence, Local / epidemiology* ; Neoplasm Recurrence, Local / pathology ; Neoplasm Recurrence, Local / prevention & control ; Republic of Korea / epidemiology ; Retrospective Studies ; Skin / pathology ; Skin Neoplasms / diagnosis ; Skin Neoplasms / mortality ; Skin Neoplasms / pathology ; Skin Neoplasms / surgery* ; Survival Rate ; Torso
Background: Obtaining conventional wide surgical margins is challenging in melanomas occurring at anatomically complex sites (e.g., hands and feet).

Objective: We investigated the potential benefits of slow Mohs micrographic surgery (MMS) for acral melanomas.

Materials and methods: This single-center retrospective study investigated 210 patients who underwent slow MMS (n = 66) or wide local excision (WLE, n = 144) for melanomas during 2005 to 2015. Slow MMS was used for melanomas in anatomically complex locations and for high-risk lesions.

Results: Acral melanoma (166/210) was the most common lesion observed in patients, in addition to head and neck (21/210) and trunk (23/210) melanomas. Slow MMS was more commonly performed for acral, and head and neck melanomas (32.5% and 52.4%, respectively) than for trunk melanomas (4.3%, p = .002). Local recurrence of acral melanomas occurred in 3.7% of patients after slow MMS and in 10.7% of patients after WLE. Multivariate analysis showed comparable prognostic outcomes between slow MMS and WLE used for acral melanomas. Compared with WLE, slow MMS resulted in a smaller postoperative defect after acral lesion excision (p < .001).

Conclusion: Slow MMS is an effective alternative to WLE for acral melanomas in anatomically complex sites, as evidenced by superior outcomes and maximum tissue conservation.
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1. College of Medicine (의과대학) > Dept. of Dermatology (피부과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sang Kyum(김상겸) ORCID logo https://orcid.org/0000-0003-0768-9923
Roh, Mi Ryung(노미령) ORCID logo https://orcid.org/0000-0002-6285-2490
Seo, Jimyung(서지명)
Oh, Yeongjoo(오영주) ORCID logo https://orcid.org/0000-0003-4973-9335
Chung, Kee Yang(정기양) ORCID logo https://orcid.org/0000-0003-3257-0297
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