Browsing by Author "Lee, Erica H."

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    Lentigo maligna melanoma mapping using reflectance confocal microscopy correlates with staged excision: A prospective study
    (2023) Navarrete-Dechent, Cristian; Cordova, Miguel; Aleissa, Saud; Liopyris, Konstantinos; Dusza, Stephen W.; Kose, Kivanc; Busam, Klaus J.; Hollman, Travis; Lezcano, Cecilia; Pulitzer, Melissa; Chen, Chih-Shan J.; Lee, Erica H.; Rossi, Anthony M.; Nehal, Kishwer S.
    Background: Lentigo maligna/lentigo maligna melanoma (LM/LMM) can present with subclinical extension that may be difficult to define preoperatively and lead to incomplete excision and potential recurrence. Preliminarily studies have used reflectance confocal microscopy (RCM) to assess LM/LMM margins.
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    Patterns of reconstruction following margin-controlled surgery for melanoma of the lentigo maligna type of the head and neck
    (Springer Nature, 2025) Navarrete Dechent, Cristian Patricio; Veldhuizen, Inge J.; Aleissa, Saud; Dusza, Stephen W.; Rossi, Anthony M.; Lee, Erica H.; Nehal, Kishwer S.
    Melanoma of the lentigo maligna (LM) type is most commonly located on the head and neck region. This subtype of melanoma poses surgical challenges due to its location on anatomically sensitive areas and frequent presence of subclinical extension. To analyze the reconstruction patterns of LM patients undergoing margin-controlled surgery. An observational study was conducted at Memorial Sloan Kettering Cancer Center, enrolling patients who underwent staged excision for the LM between November 2006 and April 2019. The study included 519 patients. Following margin-controlled surgery, the size of the surgical defects varied: <10 mm(36.2%), 10 and 30 mm (36.8%), and > 30 mm (27%). A flap reconstruction was the most common reconstructive technique (42.6%), followed by primary closure (32.6%), and graft (21.8%). Age was significantly associated with reconstruction type, with older patients more likely to undergo graft reconstructions (p = 0.014). Larger defects (> 30 mm) were reconstructed with grafts and flaps more often compared to smaller defects (p < 0.001 and p = 0.02, respectively). Understanding the scope of reconstruction is important for effective pre-surgical counseling and treatment planning. These findings highlight the importance of personalized strategies considering patients’ age and defect size.
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    Treatment of Extramammary Paget Disease and the Role of Reflectance Confocal Microscopy: A Prospective Study
    (2021) Navarrete-Dechent, Cristian; Aleissa, Saud; Cordova, Miguel; Hibler, Brian P.; Erlendsson, Andres M.; Polansky, Max; Cordova, Frank; Lee, Erica H.; Busam, Klaus J.; Hollmann, Travis; Lezcano, Cecilia; Moy, Andrea; Pulitzer, Melissa; Leitao, Mario M., Jr.; Rossi, Anthony M.
    BACKGROUND Extramammary Paget disease (EMPD) poses treatment challenges. Invasive and noninvasive treatment modalities exist with variable success reported. Reflectance confocal microscopy (RCM) is emerging as an adjuvant diagnostic tool. OBJECTIVE To evaluate the treatment of EMPD patients and the role of RCM. METHODS Prospective study. Demographic and tumor characteristics were recorded. Handheld-RCM was performed and correlated with histology. Treatment, clearance, pathology, and follow-up were all recorded. RESULTS Thirty-six EMPD lesions in 33 patients were included. Mean age was 71.7 years, and 23 were men. Mean number of surgical stages needed to clear margins was 1.9 (SD, 0.9; 1.0-3.0 stages), and mean margin needed to clear was 1.8 cm. Reflectance confocal microscopy correlated well with scouting punch biopsies (kappa, 0.93; p < .001). Disruption of the dermoepidermal junction was associated with invasive EMPD versus in situ (83.3% vs 25.9%) on histology (p = .01). Limitations Relatively small sample size. CONCLUSION Extramammary Paget disease is challenging, and lesion demarcation is of the utmost importance. Using a staged surgical excision approach, the mean margins needed were 1.8 cm, less than previously reported. Nonsurgical modalities, including radiation therapy, imiquimod, or photodynamic therapy can be considered if surgery is not pursued. Reflectance confocal microscopy is a valuable noninvasive imaging modality for the management of EMPD.
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    Tumor Board Conferences for Multidisciplinary Skin Cancer Management: A Survey of US Cancer Centers
    (2018) Mori, Shoko; Navarrete Dechent, Cristián Patricio; Petukhova, Tatyana A.; Lee, Erica H.; Rossi, Anthony M.; Postow, Michael A.; Dunn, Lara A.; Roman, Benjamin R.; Yin, Vivian T.; Coit, Daniel G.; Hollmann, Travis J.; Busam, Klaus J.; Nehal, Kishwer S.|