Functional surgery versus amputation for in situ or minimally invasive nail melanoma: A meta-analysis.

BACKGROUND

Evidence on whether functional surgery is not inferior to amputation for the treatment of in situ or minimally invasive (Breslow thickness ≤0.5 mm) nail melanoma is limited.

OBJECTIVE

To investigate the difference in local recurrence between the 2 interventions for in situ or minimally invasive nail melanoma using available published studies.

METHODS

We performed systematic search on PubMed, Embase, Cochrane Library, trial registers, and grey literature databases from inception to June 28, 2018. We included observational studies with at least 5 patients with in situ or minimally invasive nail melanoma. Main outcome was local recurrence.

RESULTS

The odds ratio synthesized from 5 studies including 109 patients (88 functional operations and 21 amputations) was 1.57 (95% confidence interval, 0.31-8.00).

LIMITATIONS: Small sample size and possible interstudy heterogeneity.

CONCLUSIONS

Our meta-analysis revealed no difference in local recurrence between the 2 interventions. Considering the functional deficit after amputation, conservative surgery should be the treatment of choice for in situ or minimally invasive nail melanoma.