BACKGROUND: Prognostic factors for patients with stage III melanoma are still controversial. METHODS: Two hundred eighty-six patients with solitary cutaneous malignant melanoma of the skin in Stage III (International Union Against Cancer [UICC]) were followed up for as long as 11 years. RESULTS: Patients in risk group pT 4a, pN O (primary tumor thickness of more than 4 mm or invasion of subcutis and absence of regional lymph node metastasis in elective lymph node specimen) have a 5-year survival rate of 72.8%. If regional metastases are excluded clinically (pT 4a, NO), the 5-year survival rate is 62.8%. Patients with regional lymph node metastases have an average 5-year survival rate of 39%, depending mainly on the number of involved lymph nodes and the depth infiltration of the primary tumor. The number of involved lymph nodes reflects the grade of dissemination. It shows a stronger correlation with the prognosis than does the size of metastases. CONCLUSIONS: The authors recommend that revisions of the UICC classification should distinguish Stage IIIA and IIIB based on the presence or absence of regional metastases and that a clearer distinction should be made between regional cutaneous or subcutaneous metastases and regional lymph node metastases.
BACKGROUND: Prognostic factors for patients with stage III melanoma are still controversial. METHODS: Two hundred eighty-six patients with solitary cutaneous malignant melanoma of the skin in Stage III (International Union Against Cancer [UICC]) were followed up for as long as 11 years. RESULTS:Patients in risk group pT 4a, pN O (primary tumor thickness of more than 4 mm or invasion of subcutis and absence of regional lymph node metastasis in elective lymph node specimen) have a 5-year survival rate of 72.8%. If regional metastases are excluded clinically (pT 4a, NO), the 5-year survival rate is 62.8%. Patients with regional lymph node metastases have an average 5-year survival rate of 39%, depending mainly on the number of involved lymph nodes and the depth infiltration of the primary tumor. The number of involved lymph nodes reflects the grade of dissemination. It shows a stronger correlation with the prognosis than does the size of metastases. CONCLUSIONS: The authors recommend that revisions of the UICC classification should distinguish Stage IIIA and IIIB based on the presence or absence of regional metastases and that a clearer distinction should be made between regional cutaneous or subcutaneous metastases and regional lymph node metastases.
Authors: Charles M Balch; Jeffrey E Gershenwald; Seng-Jaw Soong; John F Thompson; Shouluan Ding; David R Byrd; Natale Cascinelli; Alistair J Cochran; Daniel G Coit; Alexander M Eggermont; Timothy Johnson; John M Kirkwood; Stanley P Leong; Kelly M McMasters; Martin C Mihm; Donald L Morton; Merrick I Ross; Vernon K Sondak Journal: J Clin Oncol Date: 2010-04-05 Impact factor: 44.544
Authors: Rebekah R White; Wilma E Stanley; Jeffrey L Johnson; Douglas S Tyler; Hilliard F Seigler Journal: Ann Surg Date: 2002-06 Impact factor: 12.969
Authors: D Van der Velde-Zimmermann; J F Roijers; A Bouwens-Rombouts; R A De Weger; P W De Graaf; M G Tilanus; J G Van den Tweel Journal: Am J Pathol Date: 1996-09 Impact factor: 4.307
Authors: X Wang; R Heller; N VanVoorhis; C W Cruse; F Glass; N Fenske; C Berman; J Leo-Messina; D Rappaport; K Wells Journal: Ann Surg Date: 1994-12 Impact factor: 12.969
Authors: P Terheyden; A-K Kortüm; H-J Schulze; B Durani; R Remling; C Mauch; V Junghans; D Schadendorf; U Beiteke; M Jünger; J C Becker; E-B Bröcker Journal: J Cancer Res Clin Oncol Date: 2007-03-03 Impact factor: 4.322