+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Clinical and pathologic factors associated with distant metastasis and survival in patients with thin primary cutaneous melanoma



Clinical and pathologic factors associated with distant metastasis and survival in patients with thin primary cutaneous melanoma



Annals of Surgical Oncology 19(6): 1782-1789



Approximately 3-5% of patients with thin (≤ 1 mm) cutaneous melanomas develop distant metastases. We sought to identify clinical and pathologic factors associated with distant metastasis and survival in a large number of patients with thin melanoma treated at a single institution. We identified patients with a single invasive melanoma ≤ 1 mm in thickness diagnosed between January 1983 and December 2003 who developed distant metastasis (cases), and matched patients with no recorded recurrence during follow-up (control subjects). Cases and control subjects were matched for age, sex, and year of primary melanoma diagnosis. Associations of clinical and pathologic parameters with distant metastasis-free survival and melanoma-specific survival were analyzed. A total of 178 cases and 178 control subjects were identified. Factors associated with development of distant metastasis were: increasing Breslow thickness (P < 0.001), increasing Clark level of invasion (P < 0.001), increasing mitotic rate (P = 0.001), ulceration (P = 0.025), and American Joint Committee on Cancer T subcategory (P < 0.001). Multivariable models including Breslow thickness (but not Clark level) showed that factors independently associated with poorer distant metastasis-free survival were increasing age [hazard ratio (HR) 1.01, 95% confidence interval (CI) 1.00-1.02]; increasing Breslow thickness (HR 3.21, 95% CI 1.73-5.94, and HR 3.77, 95% CI 2.11-6.74 for 0.51-0.75 mm and 0.76-1.00 mm, respectively, compared with 0.01-0.50 mm); ulceration (HR 1.87, 95% CI 1.14-3.06) and mitotic rate (HR 1.13, 95% CI 1.05-1.21). Similar associations with melanoma-specific survival were found. Clinical and pathologic predictors of distant metastasis and survival identified in this large study of patients with thin primary cutaneous melanomas will enable more accurate stratification of risk of distant metastasis and poor survival in such patients, and will assist in formulating clinical management and follow-up regimens based on the level of risk.

(PDF emailed within 0-6 h: $19.90)

Accession: 036341980

Download citation: RISBibTeXText

PMID: 22350600

DOI: 10.1245/s10434-012-2265-y


Related references

Predictive factors for loco regional recurrence and distant metastasis following primary surgical treatment of cutaneous melanoma. Indian Journal of Dermatology 59(3): 241-246, 2014

Therapeutic and clinico-pathological factors in the survival of 1,469 patients with primary cutaneous malignant melanoma in clinical stage I. Virchows Archiv 408(2-3): 249-258, 1985

Presence of tumor-infiltrating lymphocytes and a dominant nodule within primary melanoma are prognostic factors for relapse-free survival of patients with thick (t4) primary melanoma: pathologic analysis of the e1690 and e1694 intergroup trials. American Journal of Clinical Pathology 133(4): 646-653, 2010

Clinical and pathologic predictors of locoregional recurrence, distant metastasis, and overall survival in patients treated with chemoradiation and mesorectal excision for rectal cancer. American Journal of Clinical Oncology 29(3): 219-224, 2006

Micrometastasis of a Sentinel Lymph Node in Cutaneous Melanoma Is a Significant Prognostic Factor for Disease-Free Survival, Distant-Metastasis-Free Survival, and Overall Survival. Dermatologic Surgery 30(10): 1319-1328, 2004

Micrometastasis of a sentinel lymph node in cutaneous melanoma is a significant prognostic factor for disease-free survival, distant-metastasis-free survival, and overall survival. Dermatologic Surgery 30(10): 1319-1328, 2004

Therapeutic and clinico-pathological factors in the survival of 1,469 patients with primary cutaneous malignant melanoma in clinical stage I. A multivariate regression analysis. Virchows Archiv. A, Pathological Anatomy and Histopathology 408(2-3): 249-258, 1985

Independent prognostic factors for distant metastases and survival in patients with primary uveal melanoma. European Journal of Cancer 40(16): 2389-2395, 2004

Clinical and pathologic predictors of locoregional recurrence (LR), distant metastasis (DM) and overall survival (OS) in patients treated with chemoradiation and mesorectal excision for locally advanced rectal cancer. Journal of Clinical Oncology 23(16_Suppl): 3597-3597, 2016

Age as key factor for pattern, timing and extent of distant metastasis in patients with cutaneous melanoma. A study of the German Central Malignant Melanoma Registry. Journal of the American Academy of Dermatology 2019, 2019

Cutaneous melanoma at the Turin Melanoma Center. II. Risk of metastasis and free interval in relation to the clinical and histological prognostic factors in 502 patients in stage I (1975-1985). Giornale Italiano di Dermatologia E Venereologia 122(4): 143-153, 1987

Factors predictive of clinical outcomes in patients with thin cutaneous melanoma. Pathology 43: S99-S100, 2011

Increased survival in distant melanoma metastasis and the effect of treatments. Analysis of the disease course of patients with a survival of 2 years or more. Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete 47(1): 35-43, 1996

Cutaneous melanoma at the Turin Melanoma Center. I. Survival and correlation with clinical and histologic prognostic factors in 502 patients in stage I (1975-1985). Giornale Italiano di Dermatologia E Venereologia 121(5): 311-326, 1986

Circulating melanoma cells and distant metastasis-free survival in stage III melanoma patients with or without adjuvant interferon treatment (EORTC 18991 side study). European Journal of Cancer 45(18): 3189-3197, 2010