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Master Thesis

Étude rétrospective de 175 mélanomes de Dubreuilh : facteurs associés au risque invasif et au risque de récidive

Abstract : Introduction: Complete surgical excision is the gold standard for treatment of lentigo melanoma (LM) but not always acceptable due to the location, size, and advanced age of patients. LM can progress into LM melanoma and in case of inadequate excision, these tumors can recur with a deeper invasive. Objectif: To evaluate clinical and histological factors associated to invasive and recurrence risk. Méthods: A retrospective study of 175 LM diagnosed in our department was conducted between august 2009 and august 2014. Résultats: Among 175 patients identified, age at diagnosis of LM was 71,1 (40-101) year. 89 (50.8%) cases were female, 86 (49.1%) cases were male. Median lesion size was 3,19 cm². Lesions occured 41,8% in the “peripheral” area (scalp, forehead, temples, ears, and neck) in men and 84,3% in the “central” area in women (other parts of the face) (P<0.001). Recurrence rate was 6,2% (local in 7 cases and metastatic in 5 cases). On univariate analysis, “peripheral” area (0,007) and phototype 3 (0,05) were found to be associated with a risk of invasion. According to multivariate analysis “peripheral” area was significant independent predictive factors of invasion (p:0,008). On univariate analysis factors significatively associated with a risk of local recurrence were: standard surgery, invasive melanoma, none or moderate inflammation, desmoplastic component and with a risk of metastatic recurrence: male gender, lesion size greater than 3 cm², “peripheral” area, s! tandard surgery, invasive melanoma. Definitive positive surgical margins were not correlated with recurrence risk. Conclusion: For indolent lesions, complete surgical excision is not the objective at all costs specially with older patients. Lesions in the “peripheral” area require more care. For aggressive lesions, surgery should be preferred.
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Master Thesis
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Submitted on : Friday, December 18, 2015 - 12:57:12 PM
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Émilie Gérard. Étude rétrospective de 175 mélanomes de Dubreuilh : facteurs associés au risque invasif et au risque de récidive. Médecine humaine et pathologie. 2015. ⟨dumas-01246335⟩

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