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Invasive malignant melanomas lacking competence for metastasis.

D E Elder, D Guerry, M N Epstein

    The American Journal of Dermatopathology
    |January 1, 1984
    PubMed
    Summary
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    The absence of vertical growth in invasive malignant melanoma indicates a near-zero risk of metastasis. Patients without this growth feature showed 100% survival after 5 years, unlike those with vertical growth.

    Area of Science:

    • Oncology
    • Dermatology
    • Pathology

    Background:

    • Malignant melanomas progress through radial and vertical growth phases.
    • Traditional microstaging (invasion level, thickness) identifies metastasis risk.
    • Vertical growth is a key indicator of melanoma aggressiveness.

    Purpose of the Study:

    • To determine the prognostic significance of vertical growth in invasive cutaneous malignant melanoma.
    • To evaluate if the absence of vertical growth correlates with improved patient outcomes.
    • To assess the risk of metastasis in melanomas lacking vertical growth phase.

    Main Methods:

    • Analysis of 211 cases of invasive cutaneous malignant melanoma.
    • Histopathological assessment for the presence or absence of vertical growth.

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  • Long-term follow-up of disease-free survival and metastasis rates.

    • Main Results:

    • 146 patients exhibited vertical growth, with a 63.7% disease-free survival rate.
    • 65 patients lacked vertical growth; 100% survived 5+ years without recurrence or metastasis.
    • Absence of vertical growth significantly reduced metastasis risk compared to traditional methods.

    Conclusions:

    • Vertical growth is a critical prognostic factor in malignant melanoma.
    • Melanomas without vertical growth represent a low-risk group with excellent prognosis.
    • Identifying the absence of vertical growth can refine patient risk stratification and management.