Review and proposal of regional surgical management for melanoma: revisiting of integumentectomy and incontinuity dissection in treatment of skin melanoma

Int J Clin Oncol. 2017 Jun;22(3):569-576. doi: 10.1007/s10147-016-1085-7. Epub 2017 Jan 7.

Abstract

Background: Past studies showed that integumentectomy and incontinuity could be effective procedures in the surgical management of melanoma patients. The present study reports on the historical background of these procedures. In addition, we analyze the ICG assisted integumentectomy and incontinuity techniques and algorithms that we had created when performing this procedure.

Method: In accordance with our algorithm, we performed ICG assisted integumentectomy/incontinuity procedures on 17 patients with stage III melanomas between 2008 and 2016. We also investigated the locoregional recurrence rate in a control group comprising 60 patients at stage III without using the algorithm.

Results: The former group exhibited a tendency of locoregional recurrence rate suppression. Melanoma cells in the dissected intervening tissue were microscopically identified in 2 out of 17 cases.

Conclusions: Our ICG assisted integumentectomy or incontinuity procedures could be effective in controlling locoregional recurrence rates in melanoma cases. Moreover, our method can be generally applied because the dissection is only performed within the lymphatic pathway region identified using indocyanine green.

Keywords: Discontinuity; Incontinuity; Indocyanine green; Integumentectomy; Locoregional recurrence rate; Melanoma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Case-Control Studies
  • Dermatologic Surgical Procedures
  • Dissection
  • Female
  • Humans
  • Indocyanine Green
  • Lymph Nodes / pathology
  • Lymphatic Vessels / pathology
  • Male
  • Melanoma / pathology
  • Melanoma / surgery*
  • Melanoma, Cutaneous Malignant
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery
  • Skin Neoplasms / pathology
  • Skin Neoplasms / surgery*
  • Surgery, Computer-Assisted / methods

Substances

  • Indocyanine Green