Prognosis for Cutaneous Melanoma by Clinical and Pathological Profile: A Population-Based Study

Abstract

IntroductionAmong white people, the incidence of cutaneous malignant melanoma (CMM) has been increasing steadily for several decades. Meanwhile, there has also been a significant improvement in 5-year survival among patients with melanoma. This population-based cohort study investigates the five-year melanoma-specific survival (MSS) for all melanoma cases recorded in 2015 in the Veneto Tumor Registry (North-Est Italian Region), taking both demographic and clinical-pathological variables into consideration.MethodsThe cumulative melanoma-specific survival probabilities were calculated with the Kaplan-Meier method, applying different sociodemographic and clinical-pathological variables. Cox’s proportional hazards model was fitted to the data to assess the association between independent variables and MSS, and also overall survival (OS), calculating the hazard ratios (HR) relative to a reference condition, and adjusting for sex, age, site of tumor, histotype, melanoma ulceration, mitotic count, tumor-infiltrating lymphocytes (TIL), and stage at diagnosis.ResultsCompared with stage I melanoma, the risk of death was increased for stage II (HR 3.31, 95% CI: 0.94-11.76, p=0.064), almost ten times higher for stage III (HR 10.51, 95% CI: 3.16-35.02, p<0.001), and more than a hundred times higher for stage IV (HR 117.17, 95% CI: 25.30-542.62, p<0.001). Among the other variables included in the model, the presence of mitoses and histological subtype emerged as independent risk factors for death.ConclusionsThe multivariable analysis disclosed that older age, tumor site, histotype, mitotic count, and tumor stage were independently associated with a higher risk of death. Data on survival by clinical and morphological characteristics could be useful in modelling, planning, and managing the most appropriate treatment and follow-up for patients with CMM.

Per- and polyfluoroalkyl substances (PFAS) exposure in melanoma patients: a retrospective study on prognosis and histological features

“…Previous studies reported an inverse association between vitamin D levels and number of mitoses [ 32 – 35 ], which may contribute to explain the higher number of mitoses in PFAS-exposed cohort in our study. In our series, mitotic index was strongly associated with patient survival as reported by many other investigators [ 36 – 38 ]. However, our data did not suggest an association between PFAS exposure and patient survival.…”

Macroscopic tumor dimension, sentinel lymph node outcome, and survival analysis among cutaneous melanoma

“…In their study, univariate analysis showed significant differences in survival between the subtypes; however in multivariate analysis with adjusted hazard ratios, they found no significant correlation between histological type and survival. Similarly, the study conducted by Buja et al, 51 identified significant differences in fiveyear survival rates among the different histological subtypes, with the nodular subtype exhibiting the poorest prognosis.…”

Histopathologic abundance of pigmentation correlates with disease‐specific survival in malignant melanoma but is not independent of current AJCC pT stage

“…Depending on the AJCC Stage, the prognosis of the patients varies considerably. For example, 5‐year survival in stage I is 99.4%, while in stage IV it drops to 23% (Buja et al, 2021).…”