Predicting five-year outcome for patients with cutaneous melanoma in a population-based study

Abstract

In this population-based study of 548 patients in Connecticut, tumor thickness was the most significant prognostic factor for survival of patients with localized cutaneous melanoma. Other prognostic factors studied to date have not been conclusively verified as providing any additional information beyond that of tumor thickness.

Prognostic instrument for survival outcome in melanoma patients: based on data from the population-based Swedish Melanoma Register

“…7 The four evaluated models showed very similar results regarding MAD. All models, except GG, separated on tumour thickness (2.1%) showed a MAD value of 2.0% for the 1 year probabilities.…”

“…(1) Mervic suggests that adding sex, age and tumour site to the AJCCclassification could improve the prediction of an individual patient's prognosis compared to the AJCC staging system currently in use (1,2). A few prognostic instruments have been presented but some are based on a limited number of patients and others are based on selected groups of patients referred to major institutions treating CMM (3)(4)(5)(6)(7)(8)(9). Hence, former instruments have not been as generalizable as expected.…”

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

“…Some studies have correlated the frequency of angiolymphatic invasion with increasing depth and level of tumor invasion, 59 while others have shown vascular invasion to be a significant predictor of metastasis 90 or of reduced survival. 11 It is perhaps the low frequency of this finding that prevented its emergence as an independent prognostic variable in many earlier series, but more recent data has shown a reduced survivorship of some 40% over 8 years when angioinvasion is demonstrated in primary tumors in vertical growth phase. 10 In modern multivariate analytic systems, angioinvasion is equivalent in prognostic import to ulceration, and second only to thickness, as a measure of survival probability.…”

“…3,6,10,11,[46][47][48][49][50][51][52][53][54] The Breslow measurement is taken from the epidermal surface or, in the event that the surface is ulcerated, from the base of the ulcer, and is made with a calibrated ocular micrometer. 3 Long clinical follow-up indicates that melanoma thickness is a continuous variable associated with dropout of survivors beyond 10 years.…”

“…Nodular melanoma lacks a radial growth phase by definition. 2,[8][9][10][11] The histologic descriptions that follow for vertical growth phase melanoma apply whether one is considering the acquisition of a vertical growth phase arising in a radial growth phase lesion of lentigo maligna melanoma, acral lentiginous melanoma, or superficial spreading melanoma, or to the de novo vertical growth phase of nodular melanoma. 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.…”