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Subtyping Cutaneous Melanoma Matters.

Mary-Ann El Sharouni1, Paul Johannes van Diest2, Arjen Joost Witkamp3

  • 1Department of Dermatology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.

JNCI Cancer Spectrum
|January 7, 2021
PubMed
Summary

Acral lentiginous melanoma (ALM) and nodular melanoma (NM) subtypes are associated with worse survival outcomes in cutaneous melanoma patients. Thin NM melanomas (≤1.0 mm) without ulceration show a significantly increased risk compared to superficial spreading melanoma (SSM).

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Area of Science:

  • Dermatology
  • Oncology
  • Epidemiology

Background:

  • Melanoma subtype significantly impacts patient survival.
  • Understanding prognostic factors like Breslow thickness and ulceration is crucial for risk stratification.

Purpose of the Study:

  • To investigate the role of different melanoma subtypes in patient survival.
  • To analyze the effects of Breslow thickness and ulceration status on survival across melanoma subtypes.

Main Methods:

  • Utilized data from the Dutch Nationwide Pathology Registry and Netherlands Cancer Registry (2000-2018).
  • Included 48,361 patients with cutaneous melanoma (Stage I-III).
  • Employed multivariable Cox proportional hazards models to calculate hazard ratios for melanoma subtypes, stratified by Breslow thickness and ulceration, adjusted for covariates.

Main Results:

  • Acral lentiginous melanoma (ALM) demonstrated significantly worse survival compared to superficial spreading melanoma (SSM).
  • Nodular melanoma (NM) showed a twofold increased risk in thin melanomas (≤1.0 mm) without ulceration versus SSM.
  • Thin NM with ulceration had a substantially higher hazard ratio (3.46) compared to thin SSM without ulceration.

Conclusions:

  • ALM is associated with poorer survival outcomes in melanoma patients.
  • Thin NM melanomas (≤1.0 mm) confer a worse prognosis than thin SSM, particularly when ulcerated.