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Six-Year Outcome of Lentigo Maligna Treated With "Spaghetti" Technique and Margin Identification by Reflectance Confocal Microscopy

  • 0Department of Oral and Maxillofacial Surgery, University Hospital of Saint-Etienne, France.
Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.] +

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December 3, 2024

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December 3, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Reflectance Confocal Microscopy (RCM) combined with the "spaghetti" surgical technique offers an effective method for managing lentigo maligna (LM) and LM melanoma (LMM). This approach achieves oncologic control with significantly reduced excision margins compared to traditional methods.

Area Of Science

  • Dermatology
  • Surgical Oncology
  • Medical Imaging

Background

  • Lentigo maligna (LM) and lentigo maligna melanoma (LMM) pose surgical challenges due to indistinct borders and facial localization, necessitating tissue-sparing techniques.
  • Achieving oncologic effectiveness while minimizing excision size is crucial for managing these skin conditions.

Purpose Of The Study

  • To evaluate the long-term outcomes of using Reflectance Confocal Microscopy (RCM) with the "spaghetti" surgical technique for LM/LMM excisions.
  • To assess the efficacy of RCM-guided margin definition in conjunction with the "spaghetti" technique for facial skin cancers.

Main Methods

  • Seventy patients with facial LM/LMM underwent RCM-guided margin identification followed by the "spaghetti" surgical technique.
  • The study utilized a cohort previously included in a 2017 study, with extended follow-up to assess long-term effectiveness.

Main Results

  • The study included 59 LMs and 11 LMMs with a mean follow-up of 6.3 years.
  • A recurrence rate of 5.7% was observed, with 3 recurrences occurring over 5 years post-procedure.
  • The mean margin from lesion to clearance was 2.7 mm, significantly smaller than conventional wide local excision margins (6.7 mm).

Conclusions

  • The "spaghetti" technique combined with RCM for margin identification is an effective management strategy for LM/LMM.
  • This approach achieves comparable recurrence rates to wide local excision but with substantially reduced tissue excision.
  • The technique demonstrates a favorable balance between oncologic safety and tissue preservation, particularly for facial lesions.