According to a study in the November/December issue of the Archives of Facial Plastic Surgery, one of the JAMA/Archives journals, carbon dioxide laser ablation (removal) may provide an alternative treatment for lentigo maligna, a common pre-cancerous skin lesion, when radiation treatment or surgery is not possible.
Lentigo Maligna (LM) is a prevalent pre-malignant skin lesion commonly located in the head and neck region. It is usually observed in older individuals with a history of chronic sun damage and might develop to LM melanoma (LMM), which has the the same prognosis as other types of melanoma.
A retrospective case series review was carried out by Haemi Lee, M.D., and colleagues at the University of Western Ontario, London, Ontario, Canada, for all individual diagnoses with primary lentigo maligna who were treated between July 2, 1991 to June 29, 2010 in London, Ontario. The team evaluated outcomes in managing primary LM through radiation therapy, carbon dioxide laser ablation and surgical excision (removal). The carbon dioxide laser targets affected tissue by vaporizing cells that contain water.
Out of the 73 participants aged 39 to 93 years who chose treatment:
- 31 patients were treated with radiation therapy and followed-up for an average of 46.3 months
- 27 patients were treated with surgical excision and followed-up for an average of 16.6 months
- and 15 were treated with carbon dioxide laser ablation and followed-up for an average of 77.8 months.
The researchers explain:
“A trend toward lower recurrence rates with surgical excision and carbon dioxide laser ablation was identified, but the results were not statistically significant.”
For surgical excision the recurrence rate were 4.2%, 6.7% of carbon dioxide ablation and 29% for radiation therapy.
The researchers state:
“Although surgical excision is established at the gold standard of LM and LMM treatment, complete excision is not always feasible in large lesions of the head and neck. The decision to perform complete excision in the setting of LM, a non-invasive disease, must weight the benefits of excision against the morbidity of the procedure.”
“Carbon dioxide laser ablation may be advantageous because it treats large lesions in cosmetically sensitive regions of the head and neck in a short period, with minimal morbidity.”
Written by Grace Rattue