Clinicopathologic Features of Cutaneous Malignant Melanoma and Their Impact on Prognosis

Abstract

Introduction: Melanoma ranks 19th among malignancies overall and second among cutaneous types. The incidence worldwide has been on the rise over the last seven decades. Various prognostic factors have been assessed and found to have a profound impact on patient outcome. However, no such studies have been attempted in our population. Our study aimed to have an insight into the behavior of malignant melanoma in our population. Materials and Methods: Cases of cutaneous malignant melanoma treated and followed up at our institute were included in this study. Cases of mucosal and choroidal melanoma were excluded. The parameters noted were age, gender, tumor thickness, Clark level, and presence of ulceration. These parameters were individually correlated with development of distant metastasis, two-year survival, survival duration, and primary tumor and lymph node stage. Appropriate statistical analyses were done. Results: Thirty patients of cutaneous malignant melanomas were treated and followed up at our institution. There was male predilection of 1:1.5. Mean age at diagnosis was 50.1 years. Twoyear survival was significantly better in females. Sun-exposed areas of the skin were most commonly involved followed by anal canal that has an unusually high incidence in our society. Majority of our cases were pT4(25) on tumor, nodal status, metastasis (TNM) staging at time of diagnosis. Increasing tumor thickness in terms of primary tumor staging was not found to have any significant impact on two-year survival, distant metastasis, lymph node stage, or survival duration. Sixty percent of cases had ulceration. There was no statistically significant effect on two-year survival (78% in ulcerated group vs 75% in nonulcerated group) and distant metastasis (61% vs 58.3%). In terms of Clark level, 20 cases were level V, seven cases were level IV, two were level III, and one was level I. There was no statistically significant difference between the Clark levels in terms of two years survival, development of distant metastasis, and lymph node stages. Conclusion: Melanoma is an aggressive malignancy that causes high morbidity and morality. It commonly presents at an advanced stage at time of diagnosis in our population. Broader studies are required with early-stage melanomas to compare the various prognostic factors and their impact on prognosis.

5-Methylcytosine immunohistochemistry for predicting cutaneous melanoma prognosis

“…The utility of the Breslow level, as emphasized by both Atique et al 25 and Rashed et al 26 , has universal acceptance in determining the prognosis of melanoma. Interestingly, Ecsedi et al 27 suggested a correlation between the Breslow depth and hypomethylation, and our investigation thoroughly confirmed this hypothesis.…”

5-Methylcytosine immunohistochemistry for predicting cutaneous melanoma prognosis

“…The utility of the Breslow level, as emphasized by both Atique et al 25 and Rashed et al 26 , has universal acceptance in determining the prognosis of melanoma. Interestingly, Ecsedi et al 27 suggested a correlation between the Breslow depth and hypomethylation, and our investigation thoroughly con rmed this hypothesis.…”

A novel Prognostic Model for Overall Survival in Patients with melanoma

“…Additionally, the AJCC staging system only incorporates tumor-related information, neglecting other patient-speci c factors such as age, the choice of surgical treatment and the presence of underlying diseases. These factors can also have an impact on the prognosis of patients [25]. Nevertheless, it is undeniable that AJCC staging remains a crucial tool for assessing the prognosis of patients [26][27][28][29].…”