Thick melanoma: the challenge persists

Murray, C.S.; Stockton, DL; Doherty, V.R.

doi:10.1111/j.1365-2133.2005.06409.x

Cited by 56 publications

(61 citation statements)

References 23 publications

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“…Increases in thick tumours were seen mainly in the older age groups and similar trends have been observed elsewhere (Murray et al, 2005). The observed increase in thin tumours may suggest a trend towards earlier diagnosis due to increased awareness, but public health campaigns directed towards early detection have been in existence since 1987 (Melia et al, 1995) and so this does not fully explain the increase in female subjects seen after 1999.…”

Section: Discussionmentioning

confidence: 52%

Recent trends in cutaneous malignant melanoma in the Yorkshire region of England; incidence, mortality and survival in relation to stage of disease, 1993–2003

2006

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The aim of this study was to investigate recent trends in incidence, mortality and survival in patients diagnosed with malignant melanoma (MM) in relation to stage (Breslow thickness). Cases of primary invasive and in situ MM diagnosed between 1st January 1993 and 31st December 2003 in the former Yorkshire Health Authority were identified from cancer registry data. Over the study period, the incidence of invasive MM increased from 5.4 to 9.7 per 100 000 in male subjects and from 7.5 to 13.1 per 100 000 in female subjects. Most of this increase was seen in thin tumours (o1.5 mm). Thin tumours were more likely to be diagnosed in the younger age groups and be classified as superficial spreading melanoma. In situ melanoma rates increased only slightly. Over the same time period, mortality rates have been relatively constant in both male and female subjects. Five-year relative survival varied from 91.8% (95% CI 90.4 -93.1) for patients with thin tumours to 41.5% (95% CI 36.7 -46.3) for those with thick tumours. In multivariable analyses, Breslow thickness was the most important prognostic factor. Age, sex and level of deprivation were also identified as independent prognostic factors. The trends in incidence suggest that the increase is real, rather than an artefact of increased scrutiny, implying that primary prevention in the Yorkshire area of the UK has failed to control trends in incidence. Mortality, in contrast, appears to be levelling off, indicating that secondary prevention has been more effective.

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Section: Discussionmentioning

confidence: 52%

Recent trends in cutaneous malignant melanoma in the Yorkshire region of England; incidence, mortality and survival in relation to stage of disease, 1993–2003

2006

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“…The negligible proportion of ''Not otherwise specified melanomas'' or ''missing cases'' observed here is in contrast with reports from general cancer registries of Europe, the US, and Australia, where the proportions of histologically unspecified melanomas may reach up to 30% of the total. 6,13 However, in the University Department of Dermatology in Tuebingen all external histopathologic diagnoses are scrutinized by internal reference histopathology with a standardized reporting schedule. Thus, the correctness and the completeness of the data generated here may be better as compared with the normal population-based cancer registries.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] During the past 2 generations the incidence of CM has risen dramatically among Caucasian populations mainly due to diagnosis of thin, prognostically favorable lesions, whereas the incidence of advanced, thick tumors generally remained stable. [4][5][6] Consequently, stabilization or even leveling off of the mortality from melanoma was reported in European, American, and Australian populations. [4][5][6][7][8][9][10] During the same period a number of new diagnostic and therapeutic modalities emerged in the field of melanoma.…”

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confidence: 99%

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Improvement of overall survival of patients with cutaneous melanoma in Germany, 1976–2001

Lasithiotakis

Leiter

Eigentler

et al. 2007

Cancer

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BACKGROUND.A hypothesis generated a retrospective analysis of the improvement of survival over time in patients with cutaneous melanoma (CM) in order to identify factors contributing to this progress.METHODS.A cohort of 4791 patients diagnosed with primary CM in southern Germany between 1976 and 2001 was analyzed. Kaplan‐Meier analyses were performed to estimate and to compare overall survival (OS) and survival after first recurrence (SAR). The Cox proportional hazards model was used to evaluate the effect of multiple variables on OS and SAR.RESULTS.Diagnosis of primary CM during 1990–2001 compared with 1976–1989 was associated with more favorable 10‐year OS (88.6% vs 80.0%, P < .0001). The median tumor thickness at primary diagnosis was significantly lower during the second period (0.75 mm vs 1.07 mm, P < .0001). In the multivariate analysis, adjusted for tumor thickness, ulceration, age, gender, and anatomical site, the period of diagnosis retained its significance as a predictor of OS (P = .002). The SAR was more favorable during the second period in patients who developed their first metastasis in the regional lymph nodes (45.2% vs 32.9%, P = .017) or in distant sites (13.4% vs 2.0%, P = .0002) and this finding persisted in the multivariate analysis.CONCLUSIONS.Improvement of survival of CM patients diagnosed 1990–2001 as compared with 1976–1989 may not be entirely attributable to factors associated with early diagnosis and more favorable primary tumors. Therefore, factors of melanoma management, which changed between the 2 time periods, such as sentinel node biopsy, adjuvant treatment, structured follow‐up, and surgical interventions in distant metastasis, may have to be taken into account. Cancer 2007 © 2007 American Cancer Society.

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“…Each wavelength reaches a different layer of the epidermis and dermis, thus grants the image data of that layer. 18 Therefore more than one wavelength calculation is crucial for detailed image of the whole skin thickness.…”

Section: Discussionmentioning

confidence: 99%

Infrared Imaging in Diagnosis of Dysplastic Nevi and Malignant Melanoma

Engın¹,

Keçici²,

Yılmaz³

et al. 2016

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of this study is to handle the subjectivity of clinical observations in the diagnosis of dysplastic nevi and malignant melanoma, by using an alternative spectrophotometric method to simple dermatoscopic examination. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Images taken by CCD (Charge-coupled Device) camera with a 1280x1024 pixel resolution which is capable of taking snapshot images between 400-1000 nm wavelengths were converted to 2048x2560 size data and were subjected to digital image processing. For each lesion, three different images were captured at selected infrared wavelenghts of 770 nm, 810 nm, 850 nm and one image with visible light. Risk score analysis of the digital image processing was carried out on two main parameters. One is surface area risk score (SAR) and the other is pixel intensity risk score (PIR). The same lesions are also evaluated dermatoscopically and ABCD scores of each lesion were calculated. R Re es su ul lt ts s: : Thirty nine patients with 47 pigmented lesions were included in the study. When all the statistical data were put together, positive correlation with ABCD scores is stronger for the images at 770 nm than the ones with 810 nm. Also when we consider all parameters which have been studied separately, the most meaningful correlation with ABCD scores was shown by "total surface area risk score". C Co on nc cl lu u--s si io on n: : Wavelengths of 770 nm and 850 nm seem to be optimal in terms of correlating with ABCD scores of the lesions. Also we need to determine the optimum wavelength range for the accurate diagnosis of melanocytic lesions.K Ke ey y W Wo or rd ds s: : Melanoma; nevus Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmanın amacı displastik nevus ve malign melanom tanısında ilk basamak olan rutin dermatoskopinin yerine alternatif spektrofotometrik yöntemler kullanılarak klinik gözlem-lerdeki subjektifliği (öznelliği) azaltmaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : 400-1000 nm arasında görüntü kaydedebilen ve 1280x1024 piksel çözünürlükte çekim yapan CCD (Charge-coupled Device) kamera ile elde edilen görüntüler, 2048x2560 büyüklükte dataya çevrilmiş ve dijital görüntüleme işlemlerine tabi tutulmuştur. Her lezyon için 770 nm, 810 nm ve 850 nm dalga boylarında ve görünür ışıkta olmak üzere dört farklı resim çekilmiştir. Dijital görüntüleme işlemleri sırasında risk skor analizleri iki parametreye göre yapılmıştır; yüzey alanı risk skoru (SAR) ve piksel yoğunluk risk skoru (PIR). Her lezyon için dermatoskopik inceleme de yapılmış ve ABCD skorları hesaplanmıştır. B Bu ul lg gu ul la ar r: : Çalışmaya toplamda 47 pigmente lezyona sahip 39 hasta dahil edilmiştir. İstatistik analizler sonucunda, kızılötesi görüntülerle ABCD skorları arasındaki ilişki 770 nm'de 810 nm'ye göre daha kuvvetli olarak saptanmıştır. Yine çalışılan tüm parametrelere bakıldığında, ABCD skoruyla "total yüzey alan risk skoru" arasındaki ilişki en yüksek bulunmuştur. S So on nu uç ç: : Lezyonların ABCD skorları 7...

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Thick melanoma: the challenge persists

Cited by 56 publications

References 23 publications

Recent trends in cutaneous malignant melanoma in the Yorkshire region of England; incidence, mortality and survival in relation to stage of disease, 1993–2003

Recent trends in cutaneous malignant melanoma in the Yorkshire region of England; incidence, mortality and survival in relation to stage of disease, 1993–2003

Improvement of overall survival of patients with cutaneous melanoma in Germany, 1976–2001

Infrared Imaging in Diagnosis of Dysplastic Nevi and Malignant Melanoma

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