Higher intraoperative detection rate of suspicious non‐palpable lesions using wire marking in skin cancer patients

Abstract

SummaryBackgroundFollow‐up protocols in patients after complete resection of high‐risk cutaneous tumors lead to a discovery of metastases in very early stages, but surgery on non‐palpable lesions proves to be challenging.Patients and methodsIn this monocenter retrospective study 39 patients suffering from malignant skin tumors with suspicious non‐palpable lesions located in the lymph nodes (90%) or deep subcutaneously/intramuscularly (10%) were included. In 21 patients the lesions were excised under ultrasound guidance, and 18 patients received a wire marking before surgery. Both patient groups were compared regarding successful intraoperative finding of the lesion, duration of the procedure, and complications.ResultsWire marking led to a significantly higher intraoperative detection rate of 100% versus 76% (p < 0.05). The average time needed for the complete procedure (p = 0.91) or the rate of complications (p = 0.70) did not differ significantly between both groups. The size of the malignant lesions successfully removed by wire marking was significantly smaller (p < 0.05). Of all 34 detected lesions only 20 (58.8%) were confirmed to be malignant.ConclusionsWire marking increases the detection rate of non‐palpable suspicious subcutaneous or lymphatic lesions. It leads to earlier diagnosis of metastasis but also allows to avoid unnecessary complete lymph node dissection.