Reasons for poor prognosis in British patients with cutaneous malignant melanoma.

Abstract

Of the 125 patients questioned, only 20 (16%) had received appropriate surgical treatment withini three months of becoming aware of a suspicious cutaneous pigmented lesion; 63 (50%) had received surgical treatment three to 12 months after first noticing such a change, and in 42 cases (34%) this interval was over one year. In 102 of 105 patients in whom the interval exceeded three months the patient alone was responsible for the delay; in only three cases was the family doctor partially at fault. No evidence of delay by the hospital service was identified. Because of these findings a public education campaign was launched in the west of Scotland in June 1985 with the aim of improving recognition of early malignant melanoma. In the next six months the proportion of patients in the west of Scotland with primary melanomas categorised as "thin, good prognosis" had-risen from 38% to 62%, and the proportion with tumours categorised as "thick, poor prognosis" had fallen from 34% to 15%. IntroductionIn a recent extensive survey of incidence and survival statistics in patients with cutaneous malignant melanoma from centres in all parts of the world the overall five year survival rate for over 8000 patients presenting with stage I malignant melanoma (mainly

Poor prognosis for malignant melanoma in Northern Ireland: a multivariate analysis

“…Thickness linked to diagnostic delay has been proposed as the reason for poor prognosis in Britain and in Ireland (Doherty & Mackie, 1986).…”

Effects of a health education campaign for the earlier diagnosis of melanoma

“…The natural history of the tumour would suggest that a thicker tumour has been present longer than a thin tumour and that consequently delay in diagnosis would lead to a poorer prognosis. Delay on the part of the patient in presenting a suspicious lesion to a doctor has been shown to make the major contribution to delay in diagnosis, and this is most often due to lack of knowledge about the seriousness of the condition (Temoshok et al, 1984;Doherty & Mackie, 1986). However, delay on the part of doctors, often due to initial failure of diagnosis, has also been recognised (Gordon & Lowry, 1986).…”

Sequential DNA Flow Cytometry in Metastatic Malignant Melanoma

“…Risk factors involved in this development have been described recently [3,4] and avoiding the exogenous ones may help to reduce the frequency of the disease. At the stage of primary melanoma, the prognosis is mainly determined by tumor thickness [5,6], Therefore, an early diagnosis is essential and the benefits of public education could be shown [7,8]. Concerning the metastatic form of the disease, our knowledge is extremely poor; In spite of multiple attempts there is no convincing therapy, physical, chemical or immunological [9], Also, to date there is no reliable prognostic parameter to estimate the probable survival time of a patient.…”