Could a Simple Biopsy Be Enough to Treat Melanoma?

According to a compelling new study published in JAMA Dermatology, a clear-margin diagnostic excisional biopsy might just be the game changer in treating melanoma in situ—offering a potential treatment path that doesn't involve extensive surgical procedures!

Led by researcher Clio Dessinioti and her team, the study analyzed 401 patients over more than three decades, uncovering some exciting insights.

Study Insights and Patient Demographics

The retrospective study focused on 401 patients, with a median age of 52. Impressively, most of the melanoma in situ cases were located on the trunk (49.9%), while the lower (24.6%) and upper extremities (17.6%) followed. These patients were meticulously monitored for at least one year, with exclusion criteria that ensured only the most relevant cases were included.

What the Findings Reveal!

The most striking outcome? Among patients treated with excisional biopsy alone who achieved clear histological margins, there were NO reported local recurrences, metastases, or melanoma-specific deaths! The only exception was a patient who didn’t follow up with wide excision, later developing invasive melanoma. This highlights the importance of initial treatment protocols.

Thirty lesions with clear margins did just fine as well, showing no recurrence even at a median follow-up of 8.1 years! Additionally, even when patients underwent wide excision with margins narrower than the standard 0.5-cm, recurrences were avoidable. Only a small percentage (1.5%) showed suspicious lesions later, all confirmed benign.

Looking Ahead: More Research Needed!

The team concluded that their findings are promising but urge caution, emphasizing that larger, more robust studies are necessary for confirmation. The hope is to establish non-invasive treatments as viable options while avoiding more extensive surgery for patients when possible.

Could this lead to a paradigm shift in how we manage melanoma in situ? Only time and further research will tell!