Surgical excision safe, effective for congenital melanocytic naevi

Surgical removal of congenital melanocytic naevi (CMN) appears to be a safe and effective treatment option, with outcomes depending on the size and location of the lesion, reports a new study.

Drawing from the online databases of PubMed, Embase, and CENTRAL, researchers retrieved 22 eligible studies corresponding to 643 patients. Nine studies were of high quality, while six and seven had moderate and low quality, respectively. High risk of bias, inconsistency, and small sample sizes resulted in a “very low” level of evidence certainty.

Overall, 288 complications were reported. Major wound-related complications occurred at a rate of 9.8 percent, while minor complications had a rate of 1.2 percent. Scar-related complications and anatomical deformities arose in 1.2 percent and 4.3 percent of treated patients.

Safety outcomes varied according to lesion size, with large or giant CMNs showing higher rates of postoperative complications.

In terms of efficacy, 24.4 percent of patients reported excellent outcomes, while only 4.6 percent said that the procedure was poor or moderate. Physician satisfaction was likewise high, with 70.1 percent rating the surgery as excellent. Data were insufficient for a pooled analysis of functional outcomes.

Histopathologically, 272 patients developed no malignancies after CMN excision, while four of 339 patients developed melanoma after excision. Seventy percent of patients achieved complete CMN excision.

“We conclude that surgical excision appears to be safe and effective in many cases, but complications can occur, depending on CMN size and location,” the researchers said. “We believe it is important to inform patients or parents about this when discussing the need for and type of surgical excision, and whether surgery would ultimately improve their quality of life.”