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Updated: Jun 18, 2025
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A 3D Organotypic Melanoma Spheroid Skin Model
Published on: May 18, 2018
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Staging in thick cutaneous malignant melanoma: A sequenced approach.
Sita Ollek1, Akie Watanabe2, Stephanie Minkova2
1Department of Surgery, Vancouver General Hospital, University of British Columbia, 899 W 12th Avenue, Vancouver, BC V5Z 1M9, Canada; BC Cancer Agency, 600 W 10th Avenue, Vancouver, BC V5Z 4E6, Canada.
Summary
Staging for thick melanoma (pT4) is inconsistent. Pre-operative imaging in these high-risk patients may improve detection of metastatic disease and guide treatment.
Area of Science:
- Oncology
- Dermatology
- Surgical Oncology
Background:
- Thick cutaneous malignant melanoma (pT4) presents a high risk for metastasis.
- Optimal staging strategies for these patients remain undefined.
- This study investigates pre-operative staging practices.
Purpose of the Study:
- To evaluate the frequency and methods of pre-operative staging in patients with pT4 cutaneous melanoma.
- To inform the development of optimal staging protocols for high-risk melanoma patients.
Main Methods:
- Retrospective analysis of 136 patients with pT4a or pT4b melanoma and clinically negative lymph nodes (2015-2017).
- Assessment of staging modalities including pre-operative imaging and sentinel lymph node biopsy (SLNB).
- Evaluation of the timing and findings of staging investigations.
Main Results:
- 19% of patients (7/36) with pre-operative imaging showed regional or distant metastatic disease.
- Upfront SLNB detected positive nodes in 22% of patients (8/36).
- Of those with negative pre-operative imaging, 3/16 had a positive SLNB.
Conclusions:
- Staging for thick melanoma is currently non-standardized and underutilized.
- Pre-operative imaging should be considered for pT4 patients.
- A defined staging approach is crucial given advancements in systemic therapies.
