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Reconstruction Principles of Localized Non-melanoma Skin Cancer and Cutaneous Melanoma

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Abstract

This chapter will mainly concentrate on basic principles for biopsy and excision of the primary tumour as well as lymph nodes and finally the reconstruction of malignant cutaneous tumours. Special reconstructive techniques for localized skin cancers of the respective body parts as well as the detailed surgical management of lymph nodes will be introduced in the following chapters. As the title of this chapter already suggests, cutaneous melanomas (CMs) are regarded as a special entity within the groups of malignant skin tumours due to their specific pathogenesis and treatment. They resemble the most feared malignant tumour with considerable morbidity and mortality.

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References

  1. Weinstein MC, Brodell RT, Bordeaux J, Honda K. The art and science of surgical margins for the dermatopathologist. Am J Dermatopathol. 2012;34:737–45.

    PubMed  Google Scholar 

  2. Lomas A, Leonardi-Bee J, Bath-Hextall F. A systematic review of worldwide incidence of nonmelanoma skin cancer. Br J Dermatol. 2012;166:1069–80.

    CAS  PubMed  Google Scholar 

  3. Eisemann N, Waldmann A, Geller AC, Weinstock MA, Volkmer B, Greinert R, et al. Non-melanoma skin cancer incidence and impact of skin cancer screening on incidence. J Invest Dermatol. 2014;134:43–50.

    CAS  PubMed  Google Scholar 

  4. Liebau J, Pallua N. Scar carcinoma as a late complication after burns. Langenbecks Arch Chir. 1995;380:158–61.

    CAS  PubMed  Google Scholar 

  5. Diepgen TL, Mahler V. The epidemiology of skin cancer. Br J Dermatol. 2002;146(Suppl 61):1–6.

    PubMed  Google Scholar 

  6. Rigel DS. Epidemiology of melanoma. Semin Cutan Med Surg. 2010;29:204–9.

    CAS  PubMed  Google Scholar 

  7. Trotter SC, Sroa N, Winkelmann RR, Olencki T, Bechtel MA. Global review of melanoma follow-up guidelines. J Clin Aesthet Dermatol. 2013;6:18–26.

    PubMed  PubMed Central  Google Scholar 

  8. Desmond RA, Soong SJ. Epidemiology of malignant melanoma. Surg Clin North Am. 2003;83:1–29.

    PubMed  Google Scholar 

  9. Fitzpatrick TB. The validity and practicality of sun-reactive skin type-I through type-Vi. Arch Dermatol. 1988;124:869–71.

    CAS  Google Scholar 

  10. Johnson RL, Rothman AL, Xie J, Goodrich LV, Bare JW, Bonifas JM, et al. Human homolog of patched, a candidate gene for the basal cell nevus syndrome. Science. 1996;272:1668–71.

    CAS  PubMed  Google Scholar 

  11. Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol. 2010;17:1471–4.

    PubMed  Google Scholar 

  12. Balch CM, Gershenwald JE, Soong SJ, Thompson JF, Atkins MB, Byrd DR, et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol. 2009;27:6199–206.

    PubMed  PubMed Central  Google Scholar 

  13. Breslow A. Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma. Ann Surg. 1970;172:902–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Clark WH Jr, From L, Bernardino EA, Mihm MC. The histogenesis and biologic behavior of primary human malignant melanomas of the skin. Cancer Res. 1969;29:705–27.

    PubMed  Google Scholar 

  15. Rutkowski P, Zdzienicki M, Nowecki ZI, Van Akkooi AC. Surgery of primary melanomas. Cancers (Basel). 2010;2:824–41.

    Google Scholar 

  16. Martin RC 2nd, Scoggins CR, Ross MI, Reintgen DS, Noyes RD, Edwards MJ, et al. Is incisional biopsy of melanoma harmful? Am J Surg. 2005;190:913–7.

    PubMed  Google Scholar 

  17. Rampen FH, van Houten WA, Jop WC. Incisional procedures and prognosis in malignant melanoma. Clin Exp Dermatol. 1980;5:313–20.

    CAS  PubMed  Google Scholar 

  18. Austin JR, Byers RM, Brown WD, Wolf P. Influence of biopsy on the prognosis of cutaneous melanoma of the head and neck. Head Neck. 1996;18:107–17.

    CAS  PubMed  Google Scholar 

  19. Lees VC, Briggs JC. Effect of initial biopsy procedure on prognosis in Stage 1 invasive cutaneous malignant melanoma: review of 1086 patients. Br J Surg. 1991;78:1108–10.

    CAS  PubMed  Google Scholar 

  20. Lederman JS, Sober AJ. Does biopsy type influence survival in clinical stage I cutaneous melanoma? J Am Acad Dermatol. 1985;13:983–7.

    CAS  PubMed  Google Scholar 

  21. Bong JL, Herd RM, Hunter JA. Incisional biopsy and melanoma prognosis. J Am Acad Dermatol. 2002;46:690–4.

    PubMed  Google Scholar 

  22. Yamashita Y, Hashimoto I, Abe Y, Seike T, Okawa K, Senzaki Y, et al. Effect of biopsy technique on the survival rate of malignant melanoma patients. Arch Plast Surg. 2014;41:122–5.

    PubMed  PubMed Central  Google Scholar 

  23. Ng JC, Swain S, Dowling JP, Wolfe R, Simpson P, Kelly JW. The impact of partial biopsy on histopathologic diagnosis of cutaneous melanoma: experience of an Australian tertiary referral service. Arch Dermatol. 2010;146:234–9.

    PubMed  Google Scholar 

  24. Ng PC, Barzilai DA, Ismail SA, Averitte RL Jr, Gilliam AC. Evaluating invasive cutaneous melanoma: is the initial biopsy representative of the final depth? J Am Acad Dermatol. 2003;48:420–4.

    PubMed  Google Scholar 

  25. Green AC, McBride P. Squamous cell carcinoma of the skin (non-metastatic). Clin Evid (Online). 2010;2010:1709.

    Google Scholar 

  26. Thomas DJ, King AR, Peat BG. Excision margins for nonmelanotic skin cancer. Plast Reconstr Surg. 2003;112:57–63.

    PubMed  Google Scholar 

  27. Brodland DG, Zitelli JA. Surgical margins for excision of primary cutaneous squamous cell carcinoma. J Am Acad Dermatol. 1992;27:241–8.

    CAS  PubMed  Google Scholar 

  28. Gillgren P, Drzewiecki KT, Niin M, Gullestad HP, Hellborg H, Mansson-Brahme E, et al. 2-cm versus 4-cm surgical excision margins for primary cutaneous melanoma thicker than 2 mm: a randomised, multicentre trial. Lancet. 2011;378:1635–42.

    PubMed  Google Scholar 

  29. Akhtar S, Bhat W, Magdum A, Stanley PR. Surgical excision margins for melanoma in situ. J Plast Reconstr Aesthet Surg. 2014;67:320–3.

    CAS  PubMed  Google Scholar 

  30. Thompson JF, Shaw HM. Sentinel node mapping for melanoma: results of trials and current applications. Surg Oncol Clin N Am. 2007;16:35–54.

    PubMed  Google Scholar 

  31. Schmitt AR, Brewer JD, Bordeaux JS, Baum CL. Staging for cutaneous squamous cell carcinoma as a predictor of sentinel lymph node biopsy results: meta-analysis of American Joint Committee on Cancer criteria and a proposed alternative system. JAMA Dermatol. 2014;150:19–24.

    PubMed  Google Scholar 

  32. White I, Fortino J, Curti B, Vetto J. Clinical impact of sentinel lymph node biopsy in patients with thick (>4 mm) melanomas. Am J Surg. 2014;207:702–7.

    PubMed  Google Scholar 

  33. Morton DL, Thompson JF, Essner R, Elashoff R, Stern SL, Nieweg OE, et al. Validation of the accuracy of intraoperative lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: a multicenter trial. Multicenter Selective Lymphadenectomy Trial Group. Ann Surg. 1999;230:453–63. discussion 463–455

    CAS  PubMed  PubMed Central  Google Scholar 

  34. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin. 2009;59:225–49.

    PubMed  Google Scholar 

  35. Dzwierzynski WW. Managing malignant melanoma. Plast Reconstr Surg. 2013;132:446e–60e.

    CAS  PubMed  Google Scholar 

  36. Pallua N, Machens HG, Rennekampff O, Becker M, Berger A. The fasciocutaneous supraclavicular artery island flap for releasing postburn mentosternal contractures. Plast Reconstr Surg. 1997;99:1878–84. discussion 1885–1876.

    CAS  PubMed  Google Scholar 

  37. Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg. 1987;40:113–41.

    CAS  PubMed  Google Scholar 

  38. Wallace CG, Kao HK, Jeng SF, Wei FC. Free-style flaps: a further step forward for perforator flap surgery. Plast Reconstr Surg. 2009;124:e419–26.

    CAS  PubMed  Google Scholar 

  39. Brunetti B, Tenna S, Aveta A, Segreto F, Persichetti P. Free-style local perforator flaps: versatility of the v-y design to reconstruct soft-tissue defects in the skin cancer population. Plast Reconstr Surg. 2013;132:451–60.

    CAS  PubMed  Google Scholar 

  40. Pallua N, Di Benedetto G, Berger A. Forefoot reconstruction by reversed island flaps in diabetic patients. Plast Reconstr Surg. 2000;106:823–7.

    CAS  PubMed  Google Scholar 

  41. Christensen L, Breiting V, Bjarnsholt T, Eickhardt S, Hogdall E, Janssen M, et al. Bacterial infection as a likely cause of adverse reactions to polyacrylamide hydrogel fillers in cosmetic surgery. Clin Infect Dis. 2013;56:1438–44.

    CAS  PubMed  Google Scholar 

  42. Perrot P, Rousseau J, Bouffaut AL, Redini F, Cassagnau E, Deschaseaux F, et al. Safety concern between autologous fat graft, mesenchymal stem cell and osteosarcoma recurrence. PLoS One. 2010;5:e10999.

    PubMed  PubMed Central  Google Scholar 

  43. Kucerova L, Matuskova M, Hlubinova K, Altanerova V, Altaner C. Tumor cell behaviour modulation by mesenchymal stromal cells. Mol Cancer. 2010;9:129.

    PubMed  PubMed Central  Google Scholar 

  44. Karagas MR, Stukel TA, Greenberg ER, Baron JA, Mott LA, Stern RS. Risk of subsequent basal cell carcinoma and squamous cell carcinoma of the skin among patients with prior skin cancer. Skin Cancer Prevention Study Group. JAMA. 1992;267:3305–10.

    CAS  PubMed  Google Scholar 

  45. Marcil I, Stern RS. Risk of developing a subsequent nonmelanoma skin cancer in patients with a history of nonmelanoma skin cancer: a critical review of the literature and meta-analysis. Arch Dermatol. 2000;136:1524–30.

    CAS  PubMed  Google Scholar 

  46. Rowe DE, Carroll RJ, Day CL Jr. Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip. Implications for treatment modality selection. J Am Acad Dermatol. 1992;26:976–90.

    CAS  PubMed  Google Scholar 

  47. Firnhaber JM. Diagnosis and treatment of Basal cell and squamous cell carcinoma. Am Fam Physician. 2012;86:161–8.

    PubMed  Google Scholar 

  48. Tan PY, Ek E, Su S, Giorlando F, Dieu T. Incomplete excision of squamous cell carcinoma of the skin: a prospective observational study. Plast Reconstr Surg. 2007;120:910–6.

    CAS  PubMed  Google Scholar 

  49. Ducic Y, Marra DE. Metastatic basal cell carcinoma. Am J Otolaryngol. 2011;32:455–8.

    PubMed  Google Scholar 

  50. Ganti AK, Kessinger A. Systemic therapy for disseminated basal cell carcinoma: an uncommon manifestation of a common cancer. Cancer Treat Rev. 2011;37:440–3.

    PubMed  Google Scholar 

  51. Lo JS, Snow SN, Reizner GT, Mohs FE, Larson PO, Hruza GJ. Metastatic basal cell carcinoma: report of twelve cases with a review of the literature. J Am Acad Dermatol. 1991;24:715–9.

    CAS  PubMed  Google Scholar 

  52. von Domarus H, Stevens PJ. Metastatic basal cell carcinoma. Report of five cases and review of 170 cases in the literature. J Am Acad Dermatol. 1984;10:1043–60.

    Google Scholar 

  53. McCusker M, Basset-Seguin N, Dummer R, Lewis K, Schadendorf D, Sekulic A, et al. Metastatic basal cell carcinoma: prognosis dependent on anatomic site and spread of disease. Eur J Cancer. 2014;50:774–83.

    PubMed  Google Scholar 

  54. Kunishige JH, Brodland DG, Zitelli JA. Surgical margins for melanoma in situ. J Am Acad Dermatol. 2012;66:438–44.

    PubMed  Google Scholar 

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Correspondence to Norbert Pallua .

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Pallua, N., Kim, BS. (2020). Reconstruction Principles of Localized Non-melanoma Skin Cancer and Cutaneous Melanoma. In: Papadopoulos, O., Papadopulos, N.A., Champsas, G. (eds) Non-Melanoma Skin Cancer and Cutaneous Melanoma. Springer, Cham. https://doi.org/10.1007/978-3-030-18797-2_7

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  • DOI: https://doi.org/10.1007/978-3-030-18797-2_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-18795-8

  • Online ISBN: 978-3-030-18797-2

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