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Updated: Jul 23, 2025
A 3D Organotypic Melanoma Spheroid Skin Model
Published on: May 18, 2018
Histologic margin status is a predictor of relapse in lentigo maligna melanoma
Mai P Hoang1, Pawel Karpinski2, Miguel Zúñiga-Castillo1
1Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Background:
Most surgical margins for lentigo maligna melanomas reported in the literature are clinical and not histologic.
Objectives:
We sought to determine whether histologic margin status is an independent predictor of progression.
Methods:
Clinicopathologic information of 268 invasive lentigo maligna melanomas diagnosed from 1990-2019 were analyzed. Statistical analyses were performed using Cox proportional hazards model and Boruta method.
Results:
A total of 75% of the lesions were located on the head and neck. The range of follow-up for all patients was 0 to 31.8 years (median, 10.2 years). Time to local recurrence ranges from 0 to 20 years (median, 3 years). Progression developed in 54 (20.1%) of 268 patients. Local recurrence was seen only in 36 (13.4%), both local recurrence and subsequent metastasis in 7 (2.6%), and only metastasis in 11 (4.1%) of 268 patients. Histologic margin status (positive and close/<3 mm) and tumor site (head and neck location) significantly correlated with worse progression-free survival.
Limitations:
Single institution and retrospective study.
Conclusions:
Histologic margin status is the strongest predictor of progression for lentigo maligna melanoma. Patients with positive or close/<3 mm histologic margins should consider a re-excision due to the increased risk of relapse.
