Prognostic factors in invasive cutaneous malignant melanoma: a population-based study and review

Abstract

A population-based study from Sweden identified 711 patients with cutaneous malignant melanoma diagnosed in 1965, 1975, 1985 and 1989. Prognostic factors were evaluated and a review of the literature was performed. On univariate analysis, thick tumours (> 0.8 mm) (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.6-2.1), increasing Clark level (OR 1.8, 95% CI 1.6-2.0), ulceration (OR 1.8, 95% CI 1.6-2.0), nodular melanoma (OR 1.5, 95% CI 1.3-1.6) and increasing age (continuous variable, P < 0.0001) were associated with a shorter survival. Location on extremities (OR 0.8, 95% CI 0.7-0.9), inflammation (OR 0.8, 95% CI 0.7-0.9) and female gender (OR 0.8, 95% CI 0.8-0.9) were associated with improved survival. On multivariate analysis, thick tumours (> 0.8 mm) (OR 1.5, 95% CI 1.2-1.7) and ulceration (OR 1.4, 95% CI 1.2-1.6) were independently related to a poor prognosis, while location on extremities (OR 0.8, 95% CI 0.7-0.9), inflammation (OR 0.8, 95% CI 0.7-0.9) and female gender (OR 0.8, 95% CI 0.8-1.0) were associated with improved survival. No difference in mean tumour thickness was seen over time, but there was a significant increase in the percentage of thin melanomas (< 0.8 mm) in 1985 (P = 0.01) and 1989 (P = 0.002) compared with 1965. The incidence of melanomas with inflammation increased significantly (P = 0.04), as did age at diagnosis (P = 0.005).

Primary ano-rectal malignant melanomas within a population-based national patient series in Sweden during 40 years

“…This is in accordance with a previous report [7] but at variance with two other reports [5,6]. Interestingly, patients with CMM in Sweden [32] and other countries [33,34] display a significantly longer survival among females than males. Multifactorial analyses have shown that gender is an independent prognostic factor for CMM [32,34].…”

“…Interestingly, patients with CMM in Sweden [32] and other countries [33,34] display a significantly longer survival among females than males. Multifactorial analyses have shown that gender is an independent prognostic factor for CMM [32,34]. Melanoma cells often display oestrogen receptors but there is no obvious relationship between the amount of sex hormones and survival in individuals with CMM [35].…”

Prognostic Factors in Cutaneous Melanoma

“…Pleiotrophin, a heparin-binding protein involved in motility and angiogenesis, is expressed in melanoma but not nevi; by univariate analysis, its expression level correlates with melanoma-related survival [ 212 ]. The major pathologic and clinical prognostic factors that have been evaluated in multivariate analyses that included >450 cases and >5-year mean follow-up [ 213 ] are summarized in Table 14.7 .…”

“…The 5-year survival with negative nodes was 97.9 % in another study [ 223 ]. Thus, lymph node involvement is often a bellwether event in Updated from Måsbäck et al [ 213 ] + signifi cant effect on prognosis, NS no signifi cant effect, − not examined a Number (%) of studies with effect on prognosis. Potency of the prognostic factors by multivariate analysis, in declining order: tumor thickness > mitotic rate > ulceration > age > gender > site >> Clark's level the natural history of melanoma.…”

A new animal model for the imaging of melanoma: correlation of FDG PET with clinical outcome, macroscopic aspect and histological classification in Melanoblastoma-bearing Libechov Minipigs

“…It has a high metastatic potential [1], and its incidence and mortality among the Caucasian population has increased markedly during the past three decades [2]. Accurate and reliable methods for the detection and grading of lesions and their extension are essential to allow early diagnosis and to evaluate new therapies, the two keys to success in tackling this important medical problem.…”