Critical appraisal:Tzellos T, Kyrgidis A, Mocellin S, Chan AW, Pilati P, Apalla Z 2014
Tzellos T, Kyrgidis A, Mocellin S, Chan AW, Pilati P, Apalla Z. Interventions for melanoma in situ, including lentigo maligna. Cochrane Database Syst Rev 2014 Dec 19;12:CD010308 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25526608.
- What are the most effective treatment/management interventions to improve outcomes in patients with lentigo maligna?
systematic review — One randomised controlled trial was included. This study involved the non-surgical treatment of 90 people with LM.
To assess the effects of all available interventions, surgical and non-surgical, for the treatment of melanoma in situ, including lentigo maligna.
- Histologic or clinical complete response rate
- Total number of acute and short-term (up to 1 year) treatment-related adverse events
- Clinical or histological local recurrence rate
- Time to complete histologic and clinical clearance, and local recurrence
- Incidence of distal metastases
- Progression to invasive melanoma
- Short-, medium-, and long-term participant satisfaction
- Treatment-related quality of lide
- Discontinuation of treatment rate because of harms
- Inflammatory response
Histological or clinical complete response was measured at 5 months in 29/44 participants (66%) treated with imiquimod plus tazarotene (combination therapy) and 27/46 participants (59%) treated with imiquimod (monotherapy).
The difference was not statistically significant: risk ratio (RR)= 1.12; 95% CI 0.81-1.55; P= 0.48.
Secondary outcomes: Recurrence and inflammation
After a mean follow-up of 42 months, no local recurrences were observed among complete responders. Difference in overall inflammation score between two groups was significant, with a mean difference of 0.6; 95% CI 0.2-1.0; P= 0.004, and the mean overall inflammation score being significantly higher in the combination group.
|Low risk of bias||Comments: Please replace this text and include any additional comments in regards to your risk of bias rating|
Risk of bias assessment: systematic review
Studies included in the review
- Very thorough – included appropriate search terms and databases
- Yes – pre-specified inclusion criteria applied independently by two people
- Yes – appropriate quality issues were assessed independently by two people
- Yes – summary descriptive tables of subjects, interventions, outcomes etc are provided and estimates of treatment effect displayed
The following questions are only relevant for systematic reviews that pooled data
- Tzellos T, Kyrgidis A, Mocellin S, Chan AW, Pilati P, Apalla Z. Interventions for melanoma in situ, including lentigo maligna. Cochrane Database Syst Rev 2014 Dec 19;12:CD010308 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25526608.
- Assigned to
- Topic area
- Clinical question
Section below only relevant for Cancer Council Project Officer