Annals of Surgical Oncology

, Volume 13, Issue 5, pp 728–739 | Cite as

Histopathologic Characteristics, Recurrence Patterns, and Survival of 129 Patients With Desmoplastic Melanoma

  • Katherine E. Posther
  • M. Angelica Selim
  • Paul J. Mosca
  • Wilma E. Stanley
  • Jeffrey L. Johnson
  • Douglas S. Tyler
  • Hilliard F. Seigler
Article

Abstract

Background

Desmoplastic melanoma (DM) has been associated with higher local recurrence rates than other types of cutaneous melanoma. Current controversies regarding locoregional treatment strategies warrant further investigation.

Methods

Retrospective review of a prospectively maintained melanoma database identified 129 patients with DM out of >12,500 melanoma patients referred for treatment from 1980 to 2003. Clinical and histopathologic characteristics, recurrence, and survival were analyzed.

Results

The median follow-up was 4.0 years. Of the 129 patients identified, 82 (63.6%) were male, and the median age was 55.2 years. American Joint Committee on Cancer staging was I, II, and III in 25.6%, 68.0%, and 6.4% of patients, respectively, and the mean tumor thickness was 4.42 mm. Overall survival was 76% at 5 years and 64% at 10 years; median survival was 13.0 years. A total of 51 patients (39.5%) experienced disease recurrence, with a median time to recurrence of 1.3 years. The first recurrence was local in 18 patients (14.0%), nodal in 18 patients (14.0%), and distant in 15 patients (11.6%), with median survivals of 6.7, 7.8, and 1.8 years, respectively. Statistically significant predictors of recurrence were a final positive margin status and stage, and predictors of overall survival were patient age and stage.

Conclusions

Compared with other types of melanoma, DMs do demonstrate a tendency toward local recurrence, thus suggesting that narrower excision margins may not be appropriate in this population. Scrutiny of final surgical margins is critical to the local management of DM. In addition, the potential for regional nodal involvement must be considered at the time of diagnosis and during surveillance for disease recurrence.

Keywords

Desmoplastic Melanoma Histopathology Recurrence Survival 

Notes

Acknowledgments

The authors thank Evelyn Nicholson, RN, and Nancy J. Pickett, RN, for their dedicated care of melanoma patients at Duke University Medical Center, for their significant contributions to the maintenance of the melanoma database, and for their assistance with this study. Supported, including statistical support and medical photography services, by the Duke Melanoma Research Fund.

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Copyright information

© The Society of Surgical Oncology, Inc. 2006

Authors and Affiliations

  • Katherine E. Posther
    • 1
  • M. Angelica Selim
    • 2
  • Paul J. Mosca
    • 3
  • Wilma E. Stanley
    • 4
  • Jeffrey L. Johnson
    • 3
  • Douglas S. Tyler
    • 1
  • Hilliard F. Seigler
    • 1
  1. 1.Department of SurgeryDuke University Medical CenterDurham
  2. 2.Department of PathologyDuke University Medical CenterDurham
  3. 3.Lehigh Valley Hospital and Health NetworkAllentown
  4. 4.Duke Comprehensive Cancer CenterDuke University Medical CenterDurham

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