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Incomplete surgical excision of lentigo maligna (LM) occurs in 16.7% of cases. Risk factors include head and neck location, narrow margins, and preoperative biopsies, highlighting the need for careful surgical planning.

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Area of Science:

  • Dermatology
  • Surgical Oncology
  • Pathology

Background:

  • Standard treatment for lentigo maligna (LM) is surgical excision.
  • Limited data exists on the frequency and risk factors for incomplete LM excisions.

Purpose of the Study:

  • To determine the incomplete excision rate (IER) in primary LM.
  • To identify risk factors associated with incomplete LM excisions.

Main Methods:

  • Retrospective analysis of 395 histopathologically confirmed LMs (2014-2020).
  • Descriptive statistics for LM characteristics and IER.
  • Univariate and multivariate analyses to identify risk factors.

Main Results:

  • The overall IER was 16.7%.
  • Risk factors for incomplete excision included head and neck lesions (p=0.0014), clinical margins <5 mm (p=0.040), and preoperative biopsies (p=0.023).
  • Plastic surgeons had higher IERs than dermatologists (p=0.036). LMs ≥20 mm had higher IERs (23.2%) than those <10 mm (12.9%).

Conclusions:

  • LM excision requires careful planning, especially for head and neck lesions.
  • At least 5-mm clinical margins are recommended.
  • Larger lesions (≥20 mm), preoperative biopsies, and plastic surgeon involvement may indicate increased surgical complexity.