Prognostic Factors for Cutaneous Melanoma

Wick, Mark R.

doi:10.1093/ajcp/110.6.713

Cited by 27 publications

(11 citation statements)

References 12 publications

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“…We not only considered the value of Ki-67 labeling in the cited differential diagnosis but also evaluated its potential role in recognition of the vertical growth phase in undisputed melanomas and paired it with concomitant p53 immunolabeling toward the same end. Growth phase in melanocytic malignancies has great significance in the estimation of overall prognosis, as recently summarized (26).…”

Section: Discussionmentioning

confidence: 99%

“…In fact, we believe that our results could be anticipated in light of accepted knowledge concerning the biology of growth phases in melanomas, as well as the observed p53 labeling data obtained in this series (15). Vertical growth (exemplified by NMMs) is accompanied by alterations in DNA content, amplification or suppression of a variety of gene complexes, and synthesis of various proteins that facilitate stromal invasion and distant metastasis (15,26). Hence, it would be logical to expect that proliferation in that growth phase would diverge from that seen in radial growth melanomas.…”

Section: Discussionmentioning

confidence: 99%

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Concurrent Ki-67 and p53 Immunolabeling in Cutaneous Melanocytic Neoplasms: An Adjunct for Recognition of the Vertical Growth Phase in Malignant Melanomas?

et al. 2000

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In attempts to extend morphologic observations in the prediction of biologic behavior, several adjunctive techniques have been applied to cutaneous melanocytic lesions of all types. These procedures have included nuclear morphometry (1); immunostaining for p53 proteins (2-4), the INK4A/CDKN2 tumor suppressor gene product (5), proliferating cell nuclear antigen (6 -8), or the Ki-67 nuclear protein (9 -13); and histochemical analysis of nucleolar organizer regions (14).A particularly challenging facet of dermatopathology concerns the more narrow setting of melanocytic malignancy. In that context, it is important to identify the growth phases (radial or vertical) of melanomas, in recognition of the prognostic importance attached to them (15). Our laboratory has

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Concurrent Ki-67 and p53 Immunolabeling in Cutaneous Melanocytic Neoplasms: An Adjunct for Recognition of the Vertical Growth Phase in Malignant Melanomas?

et al. 2000

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“…epithelioid, spindle cell); and (9) the relatively small number of tumour-infiltrating lymphocytes (non-brisk lymphocytic infiltrate is a bad prognostic factor) (Clemente et al, 1996;Wick, 1998).…”

Section: Melanoma Usually Involves the Head And Neck As Well As The Fmentioning

confidence: 99%

Clinicopathological features of melanocytic skin lesions in Egypt

Hussein

Elsers

Fadel

et al. 2006

European Journal of Cancer Prevention

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Although melanocytic skin lesions have been recognized since antiquity, their literature was limited to Caucasians. To date, the clinicopathologic features of these lesions in Egyptians are still unknown. To define these features, diagnostic records of the melanocytic skin lesions received at the Pathology Department, Assuit University Hospitals (1989-2004) were reviewed. The lesions examined included 12 benign naevi (BN), 10 dysplastic naevi (DN), and 21 cutaneous malignant melanomas (CMMs). The DN and CMMs were more common in men than in women (2 : 1 and 1.5 : 1, respectively) while BN were more common in women (2 : 1). The average age incidence was 33+/-5, 38+/-7 and 54+/-3 years, for BN, DN and CMM, respectively. The lower limb (13/21, 62%), head and neck (7/21, 33%) were the most common sites for CMMs. The average size (mm) was 2+/-0.3, 4+/-0.6 and 21+/-0.3 for BN, DN and CMMs, respectively. Recurrence occurred in 10% of CMMs. Histologically, CMMs were of nodular type and composed of epithelioid (7/21, 33%), spindle cells (1/21, 5%), or mixed cells (13/21, 62%). The mean tumour thickness (Breslow) was 6+/-0.5 mm. CMMs included two of 21(9%), three of 21(14%), six of 21(38%), and 10 of 21(38%) with Clark level II, III, IV and V. In Egypt, CMM is the third most common cutaneous neoplasm following squamous and basal cell carcinomas. Compared with Western societies, melanoma has a male sex predilection, similar histological features but different topographical distribution and rare incidence. The striking difference from Western series is the incidence of nodular melanoma - in the West this represents 15-30% of melanomas, with superficial spreading being the majority. Another key difference from the West is the 'sun-bed' culture of the West and the desire to have suntans. This is the first study that reports the clinicopathologic features of melanocytic skin lesions in Egypt.

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“…8 Other reported histopathological prognostic parameters include regression of the dermal tumour mass, vascular invasion, neurotropism and number of tumour-infiltrating lymphocytes. 5 Histopathological features with prognostic significance represent static reflections of functional characteristics. In this context, Breslow thickness represents the capacity of melanoma cells to invade through the surrounding extracellular matrix components, and ulceration represents their ability to breach the overlying epidermis.…”

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confidence: 99%

Cellular cohesion as a prognostic factor in malignant melanoma: a retrospective study with up to 12 years follow-up

Roxanis

Chow

2010

Modern Pathology

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Malignant melanomas have a high metastatic potential. Although the depth of tumour invasion is the single most important histological prognostic factor, in clinical practice this correlation is frequently challenged. In this study, we assessed the cohesion of malignant melanocytes in the dermal component of all primary melanomas in vertical growth phase with tumour thickness 40.76 mm diagnosed in our Department between 1990 and 1995. The rationale behind this morphological evaluation was based on the hypothesis that a change in the adhesion molecule profile of melanoma cells may manifest visually discrete changes in the way that cells group together in dermal aggregates. We used a dyscohesion score based on the proportion of invasive tumour occupied by dyscohesive neoplastic cells and assessed its clinical significance by correlating it with the incidence of recurrence, regional and distant metastases and survival of the patients. Follow-up was up to 12 years. We found that the degree of melanoma cell dyscohesion was associated with the probability of local recurrence or metastasis. This correlation was particularly significant when dyscohesion involving an area smaller than 25% (dyscohesion score 1) of the dermal component was compared to dyscohesion involving a larger area (scores 2-4). Melanomas in the latter group had significantly increased likelihood of recurrence or metastasis (Po0.025, log-rank test). This was particularly the case in T1-T3 melanomas (Po0.005). Similarly, T1-T3 melanomas with dyscohesion score 1 had a significantly higher survival rate (Po0.025). In the same cohort, both disease-free survival and survival were not significantly correlated to thickness, probably due to the limited number of cases. Finally, we showed that extent of dyscohesion was independent of Breslow thickness or tumour regression. We believe that estimation of melanoma cell dyscohesion is a reliable histological prognostic factor that may be appropriate in clinical practice.

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Prognostic Factors for Cutaneous Melanoma

Cited by 27 publications

References 12 publications

Concurrent Ki-67 and p53 Immunolabeling in Cutaneous Melanocytic Neoplasms: An Adjunct for Recognition of the Vertical Growth Phase in Malignant Melanomas?

Concurrent Ki-67 and p53 Immunolabeling in Cutaneous Melanocytic Neoplasms: An Adjunct for Recognition of the Vertical Growth Phase in Malignant Melanomas?

Clinicopathological features of melanocytic skin lesions in Egypt

Cellular cohesion as a prognostic factor in malignant melanoma: a retrospective study with up to 12 years follow-up

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