Thin melanoma and late recurrences: it is never too thin and never too late

Richetta, Antonio Giovanni; Bottoni, Ugo; Paolino, Giovanni; Clerico, Rita; Cantisani, Carmen; Ambrifi, Marina; Calvieri, Stefano

doi:10.1007/s12032-014-0909-4

Cited by 13 publications

(12 citation statements)

References 9 publications

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“…However, the high percentage of TM without recurrences is in contrast with a group that could develop recurrences and regional or distant metastases [ 4 – 7 ]. The TM histopathological parameters have been extensively studied in the literature and they have been associated with prognosis [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Metastases risk in thin cutaneous melanoma: prognostic value of clinical-pathologic characteristics and mutation profile

et al. 2018

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BackgroundA high percentage of patients with thin melanoma (TM), defined as lesions with Breslow thickness ≤1 mm, presents excellent long-term survival, however, some patients develop metastases. Existing prognostic factors cannot reliably differentiate TM patients at risk for metastases.ObjectiveWe aimed at characterizing the clinical-pathologic and mutation profile of metastatic and not-metastatic TM in order to distinguish lesions at risk of metastases.MethodsClinical-pathologic characteristics were recorded for the TM cases analyzed. We used a Next Generation Sequencing (NGS) multi-gene panel to characterize TM for multiple somatic mutations.ResultsA statistically significant association emerged between the presence of metastases and Breslow thickness ≥0.6 mm (p=0.003). None of TM with lymph-node involvement had Breslow thickness <0.6 mm. Somatic mutations were identified in 19 of 21 TM analyzed (90.5%). No mutations were observed in two not-metastatic cases with the lowest Breslow thickness (≤0.4 mm), whereas mutations in more than one gene were detected in one metastatic case with the highest Breslow thickness (1.00 mm).ConclusionOur study indicates Breslow thickness ≥0.6 mm as a valid prognostic factor to distinguish TM at risk for metastases.

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Section: Introductionmentioning

confidence: 99%

Metastases risk in thin cutaneous melanoma: prognostic value of clinical-pathologic characteristics and mutation profile

et al. 2018

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“…However, this trend is associated with a reduction in median tumor thickness according to Breslow depth of invasion 2 – 5 and patients with thin CM represent ∼70% of the new cases. 1 , 6 The increased frequency of thin melanoma in recent decades may be explained by an easier access to skin cancer screening clinics, but also by an overdiagnosis of melanoma by pathologists.…”

Section: Introductionmentioning

confidence: 99%

Long-term Survival of Patients With Invasive Ultra-thin Cutaneous Melanoma

et al. 2016

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The incidence of cutaneous melanoma is increasing worldwide, especially for thin melanoma (Breslow ≤1 mm). Thin cutaneous melanoma has a favorable prognosis but there are few data about the prognosis of patients with ultra-thin cutaneous melanoma (Breslow ≤ 0.5 mm). Our aim was to investigate the disease-free survival among patients with invasive cutaneous melanoma with Breslow ≤ 0.5 mm after 10 years from the initial diagnosis.A retrospective review of 240 cutaneous melanoma patients with Breslow ≤ 0.5 mm was performed. Recurrence, death from cutaneous melanoma, and disease-free survival were all identified.In the whole group of patients, we observed only 2 deaths from cutaneous melanoma. Median follow-up was 13, 11 years. Among all 240 patients, 221 were alive and disease free, 2 died of cutaneous melanoma, 11 died of other non-neoplastic diseases, 5 died of other neoplastic diseases different from melanoma, and 1 patient had a local recurrence; therefore the 10-year melanoma survival rate was 99.6%.Our data indicate that death from cutaneous melanoma in the group of patients with Breslow ≤0.5 mm was a very rare event and that diagnosis at this stage dramatically decreases the risk of developing metastatic tumors to a <0.5% also after a 10-year period of follow-up. Limitation of the study includes the fact that other risk factors for melanoma, notably ulceration, and mitotic rate, were not evaluated.

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“…For patients with LR, the median MSS time was 31 months (95% CI: 22-39), while the 1-year, 3-year and 5-year survival rates were 71.9%, 44.3% and 37.5%, respectively. For patients with ER, the median MSS time was 32 months (95% CI: [28][29][30][31][32][33][34][35], and the 1-year, 3-year and 5-year survival rates were 72.4%, 47.2% and 39.3%, respectively. There was no statistically significant difference in the MSS time between patients with LR and ER ( Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Nowadays, late recurrence of thin melanomas is a well-known entity and that is why the appropriate time and circumstance for applying sentinel lymph node biopsy is a matter of debate. 32 The relationship between late recurrences and younger age at the time of initial diagnosis is an intriguing issue. 7,[9][10][11][12][13]15 It is known that immunosurveillance, which may keep the tumour dormant, declines with age.…”

Section: Discussionmentioning

confidence: 99%

Late recurrence of melanoma after 10 years – Is the course of the disease different from early recurrences?

Saraç

Wilhelmi

Thomas

et al. 2019

Acad Dermatol Venereol

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Background It is known that melanoma can metastasize and recur many years after the first diagnosis. Although predictive and prognostic factors for melanoma are well defined, there is still insufficient information about the factors affecting the recurrence period and the effect of the recurrence time to survival. Objectives This study investigates the course of melanoma to show prognostic factors comparing early and late recurrence patients. The main objective is to uncover the effect of the recurrence time on the progression of the disease.Methods In this retrospective study, late recurrence (LR) was defined as melanoma recurrence 10 years after the first diagnosis and early recurrence (ER) was defined as recurrence within 10 years. Gender, age, localization of primary tumour, time to first metastasis, survival rates, histological subtype, stage, tumour thickness, invasion level, ulceration and regression of the primary melanoma were documented. Survival curves were evaluated using the Kaplan-Meier and compared with the log-rank test. Multivariate Cox proportional hazard models were used to identify significant independent prognostic factors for melanoma-specific survival (MSS). Results A total of 1537 melanoma patients were analysed. Early metastasis was developed in 1438 patients (93.6%), and 99 patients (6.4%) developed late metastasis. Late recurrence patients were younger (P < 0.001) and had fewer ulcerated (P = 0.005), fewer head/neck localized (P = 0.009) and thinner (P < 0.001) melanomas than ER patients. The MSS time (mean AE SD) was nearly identical for LR (31 AE 4.4 months 95% CI [22.3-39.7]) and ER (32 AE 1.9 months [28.3-35.7]). Multivariate regression analysis revealed male gender (hazard ratio [HR = 1.4, P < 0.001), truncal tumour localization (HR = 1.7, P < 0.001), tumour thickness (HR = 1.4, P < 0.045) and ulceration (HR = 1.3, P < 0.008) as significant independent prognostic factors for MSS.Conclusion Although ER and LR patients are found to have different clinicopathologic features, the time of the first recurrence after diagnosis do not seem to have an effect on the survival.

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Thin melanoma and late recurrences: it is never too thin and never too late

Cited by 13 publications

References 9 publications

Metastases risk in thin cutaneous melanoma: prognostic value of clinical-pathologic characteristics and mutation profile

Metastases risk in thin cutaneous melanoma: prognostic value of clinical-pathologic characteristics and mutation profile

Long-term Survival of Patients With Invasive Ultra-thin Cutaneous Melanoma

Late recurrence of melanoma after 10 years – Is the course of the disease different from early recurrences?

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