Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/50946
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Type: Journal article
Title: Early Cure Rates with Narrow-Margin Slow-Mohs Surgery for Periocular Malignant Melanoma
Author: Then, S.
Malhotra, R.
Barlow, R.
Kurwa, H.
Huilgol, S.
Joshi, N.
Olver, J.
Collin, J.
Selva-Nayagam, D.
Citation: Dermatologic Surgery, 2009; 35(1):17-23
Publisher: Blackwell Science Inc
Issue Date: 2009
ISSN: 1076-0512
1524-4725
Statement of
Responsibility: 
Siew-Yin Then, Raman Malhotra, Richard Barlow, Habib Kurwa, Shyamala Huilgol, Naresh Joshi, Jane Olver, Richard Collin, and Dinesh Selva
Abstract: BACKGROUND: Staged excision with rush-processed paraffin-embedded tissue sections (Slow-Mohs) is an effective treatment for periocular melanoma. Although there is no consensus on initial margins of excision, narrower margins in the eyelids have the functionally and cosmetically important consequence of smaller postoperative wounds. OBJECTIVES: To report early cure rates for periocular melanoma using Slow-Mohs surgery with en-face margin sectioning. METHODS: Retrospective, multicenter, noncomparative case series. Slow-Mohs surgery in 14 patients with periocular melanoma from 2000 to 2006. RESULTS: Fourteen patients underwent 14 Slow-Mohs procedures for eight lentigo maligna, one nodular, and one superficial spreading melanoma, and four lentigo maligna, 12 primary, and two recurrent tumors. The most common site was the lower eyelid (8/14, 57.1%). Breslow thickness ranged from 0.27 to 1.70 mm, with four cases less than 0.76 mm and one case greater than 1.5 mm. Five cases were a Clark level II or greater. Complete excision was achieved with one level (6 cases) or two or three levels (8 cases), with 2- to 3-mm margins at each level in all but one case. With median follow-up of 36 months, there were two local recurrences (2/14, 14.3%). CONCLUSION: Slow-Mohs with en-face sections achieves similar early cure rates to previously published margin-controlled excision techniques. Narrow margins of excision can optimize tissue preservation without compromising outcome.
Keywords: Eye; Humans; Melanoma; Hutchinson's Melanotic Freckle; Facial Neoplasms; Eyelid Neoplasms; Treatment Outcome; Mohs Surgery; Retrospective Studies; Aged; Aged, 80 and over; Middle Aged; Female; Male
Description: © 2009 American Society of Dermatologic Surgery
RMID: 0020090033
DOI: 10.1111/j.1524-4725.2008.34377.x
Appears in Collections:Medicine publications

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