Relationship between melanoma detection pattern and tumor thickness

Melanoma tumor thickness remains the most important determinant of patient survival. Several large population-based studies have shown that full-body skin examinations (FBSE) improve melanoma mortality and others that FBSEs may detect melanomas at a thinner, more curable stage.

To relate the detection method to lesion thickness at the time of diagnosis.

A retrospective chart review of all cases of biopsy-proven primary cutaneous melanomas diagnosed from 2000 to 2012 at the Veterans Affairs Hospital in Brooklyn NY was conducted. Data were collected in 2012-2013 and analyzed in 2013. Main outcome measures include lesion thickness stratified by method of detection and probabilities of detecting thin lesions per method (using cut-offs of in situ and 0.75 mm). Secondary outcomes include interaction between method and body site or lesion diameter.

Sixty-three percent of melanomas were detected by FBSE and 59% of all melanomas were in situ. There was no statistically significant difference in thickness among the detection groups when a cut-off of in situ (Fisher's exact test, p=0.6148) or 0.75 mm was used (p=0.8910). A majority of lesions on the back were found by FBSE (68%).

FBSE was not shown to detect melanomas at a thinner stage. Prospective studies are needed to analyze the utility and efficacy of FBSEs in clinical practice.