TDNet Discover

Malignant melanoma is the deadliest form of skin cancer, and its incidence in the population is increasing. Much of the literature pertaining to the treatment of melanoma focuses on new therapeutics for invasive, late stage melanoma. However, controversy exists regarding the best treatment option for in situ and early stage invasive melanomas. While Wide Local Excision (WLE) remains the standard of care, another method, Mohs Micrographic Surgery (MMS), may be an effective alternative treatment option for primary tumor excision. Through a systematic review of the literature conducted by three researchers, this study investigates the efficacy of MMS in terms of survival, recurrence rates, and adverse effects when compared with WLE for the treatment of adults with early stage melanomas in various anatomical locations. The researchers searched PubMed, Discover Search, Google Scholar, and JAMA Dermatology databases for articles comparing surgical treatment methods for melanoma in the last 10 years. The four databases were searched using specific search terms and phrases in duplicate by three independent researchers, and any changes in search procedures were agreed upon as a group. As a group, the researchers reviewed the titles, abstracts and full text of each article to ensure chosen articles met all the research criteria. This review procedure yielded a total of eight studies to be utilized in this systematic review. Seven of the eight studies were retrospective cohort studies, and the study by Rosko et al. (2017) was the only systematic review. Quality assessment of the articles meeting inclusion criteria was conducted along with qualitative analysis of the data extracted. Four of the eight studies received a quality of good while the four other studies received a quality of fair. Two major outcomes after surgical treatment were assessed and WLE VERSUS MMS FOR ADULT MELANOMA v included survivability in all eight studies and recurrence rates in six of the eight studies. A minor outcome that was not specifically defined or assessed in the studies included adverse effects such as cosmetic function. Four of the eight articles analyzed in this review found statistically significant evidence in one or more outcomes that favored MMS over WLE treatment for malignant melanoma. The remaining four articles also found that MMS favored WLE regarding outcomes, but the results were not of statistical significance. The findings yielded in this review suggest that MMS can be considered an effective alternative treatment option for melanoma, and it may be considered favorable over WLE in some cases. This information should be considered by clinicians to aid in deciding between MMS and WLE for the treatment of melanoma in adults based on type, stage, and anatomical location of the tumor.