Evaluation and Surgical Management of Pediatric Cutaneous Melanoma and Atypical Spitz and Non-Spitz Melanocytic Tumors (Melanocytomas): A Report From Children's Oncology Group.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sargen Michael R, Barnhill Raymond L, Elder David E, Swetter Susan M, Prieto Victor G, Ko Jennifer S, Bahrami Armita, Gerami Pedram, Karunamurthy Arivarasan, Pappo Alberto S, Schuchter Lynn M, LeBoit Philip E, Yeh Iwei, Kirkwood John M, Jen Melinda, Dunkel Ira J, Durham Megan M, Christison-Lagay Emily R, Austin Mary T, Aldrink Jennifer H, Mehrhoff Casey, Hawryluk Elena B, Chu Emily Y, Busam Klaus J, Sondak Vernon, Messina Jane, Puig Susana, Colebatch Andrew J, Coughlin Carrie C, Berrebi Kristen G, Laetsch Theodore W, Mitchell Sarah G, Seynnaeve Brittani
Аннотация
METHODS: A Children's Oncology Group-led panel with external, multidisciplinary CM specialists convened to develop recommendations on the basis of available data and expertise.
RESULTS: Thirty-three experts from multiple specialties (cutaneous/medical/surgical oncology, dermatology, and dermatopathology) established recommendations with supporting data from 87 peer-reviewed publications.
RECOMMENDATIONS: (1) Excisional biopsies with 1-3 mm margins should be performed when feasible for clinically suspicious melanocytic neoplasms. (2) Definitive surgical treatment for CM, including wide local excision and sentinel lymph node biopsy (SLNB), should follow National Comprehensive Cancer Network Guidelines in the absence of data from pediatric-specific surgery trials and/or cohort studies. (3) Accurate classification of ASTs as benign or malignant is more likely with immunohistochemistry and next-generation sequencing. (4) It may not be possible to classify some ASTs as likely/definitively benign or malignant after clinicopathologic and/or molecular correlation, and these Spitz tumors of uncertain malignant potential should be excised with 5 mm margins. (5) ASTs favored to be benign should be excised with 1- to 3-mm margins if transected on biopsy. (6) Re-excision is not necessary if the AST does not extend to the biopsy margin(s) when complete/excisional biopsy was performed. (7) SLNB should not be performed for Spitz tumors unless a diagnosis of CM is favored on clinicopathologic evaluation. (8) Non-Spitz melanocytomas have a presumed increased risk for progression to CM and should be excised with 1- to 3-mm margins if transected on biopsy. (9) Re-excision of non-Spitz melanocytomas is not necessary if the lesion is completely excised on biopsy.