Functional surgery versus amputation for in situ or minimally invasive subungual melanoma: A systematic review and meta-analysis using individual patient data = Functional surgery versus amputation for in situ or minimally invasive subungual melanoma: A systematic review and meta-analysis using individual patient data

다국어 초록 (Multilingual Abstract)

Background: Evidence for which surgical treatment is appropriate for in situ or minimally invasive (Breslow thickness < 0.5mm) subungual melanoma between functional surgery and amputation is lacking.
Objectives: To investigate the difference in local recurrence between the two interventions for in situ or minimally invasive subungual melanoma using available published literature
Methods: We performed systematic search on Pubmed, EMBASE, Cochrane library, trial registers, and grey literature databases from inception to June 28, 2018. Due to lack of randomized controlled trial, we included observational studies with at least 5 in situ or minimally invasive subungual melanoma cases. Main outcome was local recurrence.
Results: Odds ratio synthesized from 5 comparative studies including 110 patients (89 functional surgery and 21 amputation) was 1.57 (95% confidence interval: 0.31-8.00). Log-rank test using individual patient data of 75 patients (63 functional surgery and 12 amputation) from 3 comparative studies and 5 non-comparative studies, showed no statistical difference (P=0.225).
Conclusion: Our results revealed there is no difference in terms of local recurrence between the two interventions for in situ or minimally invasive subungual melanoma. Considering functional deficit following amputation, functional surgery should be the treatment of choice for in situ or minimally invasive subungual melanoma.