BACKGROUND: Although thin cutaneous melanomas generally have a favorable prognosis, in some cases they may undergo progression. The current study was undertaken to identify variables that may predict a more aggressive clinical outcome in these patients. In addition to classic clinicopathologic features, the authors tested the prognostic impact of three new morphometric quantitative parameters: 1) tumor thickness plus regression thickness (T+R), 2) percentage of skin thickness infiltrated by tumor cells (T/S ratio), and 3) percentage of skin thickness infiltrated by tumor cells and regression ([T+R]/S ratio). METHODS: The authors retrospectively evaluated 287 patients with invasive cutaneous melanoma < or = 1.5 mm in thickness. Disease free survival rates (Kaplan-Meier method) were compared by using the log rank test. A multivariate analysis (Cox proportional hazards model) was used to determine the independent effect of each variable on progression. Progression was defined as any documented cutaneous local and/or distant metastasis. RESULTS: Thirty-two of the 287 patients (11.1%) underwent disease progression. The overall 5-year and 10-year disease free survival rates were 89.3% and 84.6%, respectively. In the univariate analysis, the following factors were found to be significant predictors of progression: male gender (P = 0.01), acral-lentiginous histotype (P = 0.02), tumor thickness (P = 0.005), T+R (P = 0.001), T/S ratio > or = 50% (P = 0.03), (T+R)/S ratio > or = 50% (P = 0.006), vertical growth phase (P = 0.04), and absence of inflammatory response (P < 0.0001). Conversely, age, site, and Clark's level did not affect the risk of recurrences and/or metastases significantly. In the multivariate analysis, only T+R (P = 0.009) and inflammatory response (P < 0.0001) were found to be independent predictors of progression. Five-year disease free survival rates according to presence versus absence of inflammatory response were 93.4% and 63.8%, respectively (P < 0.0001). CONCLUSIONS: In the current study, peritumoral and intratumoral inflammatory infiltrate and T+R were found to be strong independent predictors of progression in thin cutaneous melanomas.
BACKGROUND: Although thin cutaneous melanomas generally have a favorable prognosis, in some cases they may undergo progression. The current study was undertaken to identify variables that may predict a more aggressive clinical outcome in these patients. In addition to classic clinicopathologic features, the authors tested the prognostic impact of three new morphometric quantitative parameters: 1) tumor thickness plus regression thickness (T+R), 2) percentage of skin thickness infiltrated by tumor cells (T/S ratio), and 3) percentage of skin thickness infiltrated by tumor cells and regression ([T+R]/S ratio). METHODS: The authors retrospectively evaluated 287 patients with invasive cutaneous melanoma < or = 1.5 mm in thickness. Disease free survival rates (Kaplan-Meier method) were compared by using the log rank test. A multivariate analysis (Cox proportional hazards model) was used to determine the independent effect of each variable on progression. Progression was defined as any documented cutaneous local and/or distant metastasis. RESULTS: Thirty-two of the 287 patients (11.1%) underwent disease progression. The overall 5-year and 10-year disease free survival rates were 89.3% and 84.6%, respectively. In the univariate analysis, the following factors were found to be significant predictors of progression: male gender (P = 0.01), acral-lentiginous histotype (P = 0.02), tumor thickness (P = 0.005), T+R (P = 0.001), T/S ratio > or = 50% (P = 0.03), (T+R)/S ratio > or = 50% (P = 0.006), vertical growth phase (P = 0.04), and absence of inflammatory response (P < 0.0001). Conversely, age, site, and Clark's level did not affect the risk of recurrences and/or metastases significantly. In the multivariate analysis, only T+R (P = 0.009) and inflammatory response (P < 0.0001) were found to be independent predictors of progression. Five-year disease free survival rates according to presence versus absence of inflammatory response were 93.4% and 63.8%, respectively (P < 0.0001). CONCLUSIONS: In the current study, peritumoral and intratumoral inflammatory infiltrate and T+R were found to be strong independent predictors of progression in thin cutaneous melanomas.
Authors: Andrea Maurichi; Rosalba Miceli; Hanna Eriksson; Julia Newton-Bishop; Jérémie Nsengimana; May Chan; Andrew J Hayes; Kara Heelan; David Adams; Roberto Patuzzo; Francesco Barretta; Gianfranco Gallino; Catherine Harwood; Daniele Bergamaschi; Dorothy Bennett; Konstantinos Lasithiotakis; Paola Ghiorzo; Bruna Dalmasso; Ausilia Manganoni; Francesca Consoli; Ilaria Mattavelli; Consuelo Barbieri; Andrea Leva; Umberto Cortinovis; Vittoria Espeli; Cristina Mangas; Pietro Quaglino; Simone Ribero; Paolo Broganelli; Giovanni Pellacani; Caterina Longo; Corrado Del Forno; Lorenzo Borgognoni; Serena Sestini; Nicola Pimpinelli; Sara Fortunato; Alessandra Chiarugi; Paolo Nardini; Elena Morittu; Antonio Florita; Mara Cossa; Barbara Valeri; Massimo Milione; Giancarlo Pruneri; Odysseas Zoras; Andrea Anichini; Roberta Mortarini; Mario Santinami Journal: J Clin Oncol Date: 2020-03-13 Impact factor: 44.544
Authors: Steven Morrison; Gang Han; Faith Elenwa; John T Vetto; Graham Fowler; Stanley P Leong; Mohammed Kashani-Sabet; Barbara Pockaj; Heidi E Kosiorek; Jonathan S Zager; Jane L Messina; Nicola Mozzillo; Schlomo Schneebaum; Dale Han Journal: Ann Surg Oncol Date: 2022-01-21 Impact factor: 5.344
Authors: Shelly X Bian; Lindsay Hwang; Jennifer Hwang; Omar Ragab; Gino K In; David Peng; Eugene Lin Journal: Pigment Cell Melanoma Res Date: 2021-08-02 Impact factor: 4.693