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High Keloid Recurrence After Surgery, Radiotherapy

Procedure should be used as last resort

WEDNESDAY, June 27 (HealthDay News) -- Treatment of therapy-resistant keloids with surgery and radiotherapy is subject to a large recurrence rate and should be used only as a last resort, according to a report in the June issue of Plastic and Reconstructive Surgery.

Mick Kreulen, M.D., Ph.D., of the Academic Medical Center in Amsterdam, the Netherlands, and colleagues conducted a clinical outcome study to measure the recurrence rate of therapy-resistant keloids after surgery and irradiation. Recurrence is defined as elevation of a lesion not confined to the original wound area.

During a mean 19-month follow-up, the investigators found the recurrence rate in 21 patients with 32 keloids was 71.9 percent. Recurrence rates after surgery and radiotherapy reported in the literature varied widely and ranged from 2 percent to 72 percent.

"On the basis of our results and despite the fact that we did not encounter serious adverse effects of radiotherapy, we are reluctant to advocate widespread use of this possibly malignant treatment for a benign disorder," the authors write. "Until proof is provided otherwise, we feel that surgical excision combined with immediate radiotherapy should be preserved as a last resort in the treatment of therapy-resistant keloids."

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