Cutaneous melanoma in Japan and the United States: comparative prognostic factors

The ability to predict outcome for an individual patient with melanoma is important not only for the prognostic interests of the particular patient involved, but also for the design and accurate interpretation of surgical and adjuvant therapy studies. Comparison of prognostic studies between centers in the United States and Japan may result in understanding biologic differences between the disease as it manifests in whites and mongoloids. Studies from the Melanoma Clinical Cooperative Group (U.S.A.) and from Tohoku University (Japan) show some significant similarities and some differences. Overall five-year survival is quite different for clinical state I patients, 85% and 65%, respectively. However, when five-year survival for lesions on the hands and feet in the U.S. series is compared with the mainly acral melanomas in the Japanese series, the results show five-year survivals of 63% and 73%, respectively. Comparison of five-year survivals for clinical stage I acral lentigenous melanoma of the soles subdivided by thickness would establish whether data from the large series collected in the United States can be extrapolated to melanoma behavior in Japan.