Outcomes of Transected Melanoma Diagnosed by Shave Biopsy: A Single-Institution Retrospective Analysis.

BACKGROUND

In the histologic analysis of melanoma, Breslow depth is a critical component of prognostication. Transecting the tumor through tangential biopsy technique potentially affects staging, treatment, and outcomes.

OBJECTIVE

Compare outcomes of transected and nontransected melanomas biopsied by tangential biopsy technique.

PATIENTS AND

METHODS

This is a single-center retrospective cohort study. Patients were matched based on American Joint Commission on Cancer eighth edition Tumor (T) stage and tumor transection status.

RESULTS

Patients with transected melanomas experienced significant increases in 5-year recurrence ( p = .023), 5-year mortality ( p = .004), metastasis ( p = .035), and melanoma-related mortality ( p = .002). However, after stratifying by T stage, there were no significant differences in recurrence, metastasis, or mortality between transected and nontransected tumors. Transected tumors <1.0 mm had a higher rate of sentinel lymph node biopsies (SNLB) performed compared with the nontransected tumors <1.0 mm. Limitations include population size, single-institution retrospective nature of the study, and homogenous population.

CONCLUSION

While there were no significant differences in patient outcomes by T stage when melanomas were transected by shave biopsy, shallow (<1.0 mm) transected melanomas were more likely to receive sentinel lymph node biopsy compared with nontransected melanomas. Biopsy technique should aim to a depth that provides the full Breslow depth of melanoma tumors.