Prognostic Factors for Melanoma Patients with Lesions 0.76–1.69 mm in Thickness An Appraisal of “Thin” Level IV Lesions

Abstract

Fourteen variables were tested for their prognostic usefulness in 203 patients with clinical Stage I melanoma and primary tumor 0.76-169 mm thick. Only two variables, primary tumor location and level of invasion, were useful in predicting death from melanoma for these patients. Of the 12 deaths from melanoma, 11 occurred in patients with primary tumors located on the upper back, posterior arm, posterior neck, and posterior scalp (=BANS). There has been only one death from melanoma in 136 patients with melanoma located at other sites (11/67 vs 1/136, p less than 0.0001 Fisher's Exact Test). Of the 67 BANS patients, 51 had level II or level III lesions and five (10%0 died of melanoma. This compared with six deaths from melanoma in 16 patients (37.5%) with level IV BANS lesions (5/51 vs 6/16, p = 0.01 Fisher's Exact Test). The relatively high incidence of both melanoma deaths and regional node metastases for the BANS group merits consideration for testing the efficacy of elective regional node dissection for these patients.

Histological Characteristics of Metastasizing Thin Melanomas

“…7,9,[16][17][18] Despite numerous studies on the subject, the clinical and pathological risk factors for these MTMs are largely unclear. This problem is partly because of variations in the defining criteria for thin melanomas used in prior studies, 7,19 with Breslow thickness varying from 0.76 mm to 1.69 mm. Furthermore, some investigations combined recurring lesions with MTMs, further confounding the results.…”

Prognosticators of melanoma, the melanoma report, and the sentinel lymph node

“…Therapy and prognostication depend on the pathologist's ability to accurately identify by light microscopy the vertical growth phase, as it defines the point in lesional evolution when a melanoma acquires the ability to metastasize and to kill the patient. [12][13][14][15] Radial vs Vertical Growth Phase…”

The Role of Microsatellites as a Prognostic Factor in Primary Malignant Melanoma

“…[1][2][3]5,6 In the present study, we examine the role of microsatellitosis as a predictive marker of outcome associated with melanoma.…”