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Updated: Oct 14, 2025
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A Melanoma Patient-Derived Xenograft Model
Published on: May 20, 2019
12.6K
Management of Transected Invasive Melanoma: A Single Institution Retrospective Review
James Robert Duncan1, Lauren L Beal2, Andrew Daugherty1
1Department of Dermatology, University of Alabama Birmingham, Birmingham, Alabama.
Summary
Deep melanoma transection can alter tumor staging. Upstaging occurred in 13.6% of cases, influenced by broad transection and residual tumor, impacting treatment recommendations.
Area of Science:
- Dermatology
- Surgical Pathology
- Oncology
Background:
- Accurate Breslow depth measurement is crucial for invasive melanoma staging.
- Deep transection during biopsy can compromise Breslow depth assessment.
- This impacts the accuracy of tumor staging and subsequent management.
Purpose of the Study:
- To determine the frequency of upstaging in transected invasive melanomas.
- To characterize the impact of upstaging on National Comprehensive Cancer Network (NCCN)-recommended treatment.
- To identify predictors of melanoma upstaging after deep transection.
Main Methods:
- Retrospective review of 726 invasive melanomas (January 2017-December 2019).
- Comparison of deeply transected biopsy reports with subsequent excisions.
- Analysis of factors influencing upstaging and treatment alteration.
Main Results:
- 360 (49.6%) melanomas were transected; 49 (13.6%) showed upstaging affecting NCCN management.
- Broad transection (21.7%) led to more frequent upstaging than focal transection (4.9%).
- Gross residual tumor/pigment post-biopsy predicted higher upstaging likelihood (47.1% vs 6.9%).
Conclusions:
- Upstaging of deeply transected melanomas impacts management in 13.6% of cases.
- Broad transection and presence of residual tumor/pigment are key predictors of upstaging.
- These findings highlight the importance of careful biopsy technique and histopathological assessment.
