Evaluation of prognostic characteristics of stage I cutaneous malignant melanoma.

The prognostic characteristics of stage I cutaneous malignant melanoma were evaluated. For this purpose, all patients with malignant melanomas diagnosed between January 1, 1967, and December 31, 1982, at the Department of Pathological Anatomy of the S.S.D.Z. were examined. Of the 187 total cases of malignant melanoma, 169 patients had stage I disease. Of these, 101 were not included in the investigation for the following reasons: carcinoma in situ (2), previous radiation treatment (1), localization in mucous membrane (2), microscopic sections unsuitable for morphometry and measurement of tumor thickness (11), follow-up period shorter than 60 months (61), lost for follow-up (12) and cause of death unrelated to melanoma (12). Of the remaining 68 patients, 46 had been alive without metastases for at least 60 months ("survivors") and 22 had died from metastases within 60 months ("nonsurvivors"). The following parameters were investigated: age, sex, localization, histologic type, level of invasion according to Clark and Breslow, ulceration, mitotic activity index, morphometric parameters (relating to nuclear shape and size) and number, size and localization of nucleoli. Wilcoxon's test and the chi-square test showed significant differences between survivors and nonsurvivors with regard to ulceration (P = 0.005), mitotic activity index (P = 0.006), histologic type (P = 0.03), level of invasion according to Clark (P = 0.004), Breslow tumor thickness (P = 0.003), standard deviation of nuclear contour index (P = 0.04) and nuclear correlation coefficient (P = 0.008). The results showed that tumor thickness of cutaneous malignant melanoma is the most significant prognostic parameter.(ABSTRACT TRUNCATED AT 250 WORDS)