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Reflectance Confocal Microscopy Agrees With Histopathology in Lentigo Maligna

Good agreement seen between RCM and histopathology for patients with lentigo maligna/lentigo maligna melanoma undergoing staging excision

By Dermsquared Editorial Team | February 22, 2023

For patients with lentigo maligna/lentigo maligna melanoma (LM/LMM) undergoing staged excision, reflectance confocal microscopy (RCM) margin assessment has good overall agreement with final histopathology, according to a study published in the February issue of the Journal of the American Academy of Dermatology.

Cristian Navarrete-Dechent, M.D., from the Pontificia Universidad Catolica de Chile in Santiago, and colleagues conducted a prospective study of 72 LM/LMM patients referred for dermatologic surgery. RCM was performed at the clinically defined initial surgical margin followed by margin-controlled staged excision; histopathology was correlated with results from RCM.

Seventy of the 72 lesions were located on the head and neck; the mean largest clinical diameter was 1.3 cm. The researchers found that compared with histopathology, detection of residual melanoma in the tumor debulk (after biopsy) had a sensitivity of 96.7 percent and a specificity of 66.7 percent. Overall agreement for RCM margin assessment with final histopathology was 85.9 percent (κ = 0.71).

"Going forward, LM/LMM RCM mapping may provide important benefits by improving surgical planning, reducing the 'unknown' factor, and potentially reducing the number of surgical stages, which ultimately can reduce costs and improve patient satisfaction," the authors write.

One author disclosed financial ties to the biopharmaceutical industry; a second author disclosed receipt of royalties from publishing companies.

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