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Low Rate of Melanoma Upstaging After Initial Biopsy (Fernung et al.)

Juhasz M, Young JN, Azzawi S, et al.
Dermatologic Surgery (2024)

JC: January 2025

This study by Fernung et al. evaluated the rate of melanoma upstaging (increased T-stage) at definitive excision compared to the initial biopsy diagnosis. The low upstaging rate observed provided reassurance regarding the reliability of initial biopsy staging for treatment planning in most melanoma cases.

Take-Home Messages

  • •Melanoma upstaging at definitive excision is relatively uncommon, supporting the reliability of initial biopsy for staging and management decisions.
  • •Despite the low upstaging rate, complete excision with adequate margins remains important for accurate final pathologic staging.
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Topic

Melanoma

Melanoma margins, SLNB, staging, Mohs for melanoma in situ

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Tumor Melanoma

Abstract

Mohs micrographic surgery (MMS) is used for melanoma in situ (MIS) and thin invasive melanomas, particularly on the head and neck, during which a debulk section is typically prepared. Tumor upstaging occurs if the debulking specimen meets criteria for an increased tumor (T) stage per the American Joint Committee on Cancer 8th edition compared with the initial biopsy. Upstaging can alter survival and recurrence outcomes, resulting in increased patient morbidity and mortality. To determine the ...

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Literature review only. This summary is an editorial interpretation and may not reflect the complete findings of the original publication. Always refer to the full-text article for clinical decision-making.