Statistical survey from 1982 to 1991 of 49 patients with malignant melanocytic tumors

We investigated the clinical characteristics and outcome of 49 patients with malignant melanoma: 17 with acral lentiginous melanoma; 14 with nodular melanoma, six with superficial spreading melanoma, one with lentigo maligna melanoma, eight with melanoma in situ, one with malignant blue nevus, and two with melanoma of unknown origin. Of the 41 patients without melanoma in situ, 34.1% were in stage I, 17.1% in stage II, and 48.8% in stage III. No patients had reached stage IV. All patients with stage I, II, and III melanoma were treated with wide resection, lymph node dissection including prophylactic dissection, and combination chemotherapy with dacarbazine, nimustine hydrochloride, and vincristine (DAV) with or without Interferon-beta. The statistical analysis revealed that tumor thickness and level of invasion were factors significantly associated with outcome. A gradual increase in the number of new cases of melanoma was seen each year of the registration period (1982-1991); there was an approximately 4-fold increase during this decade over the previous decade. The majority of the primary lesions (80.5%) were located on the upper or lower extremities, the pT4 tumor thickness subgroup was the most frequent (39.0% of all melanomas), and invasion level IV was the most common (42.5%). About half (51.2%) of the melanoma patients were stage I or II; this group had a 5-year survival rate of 100%. The stage III patients had a 5-year survival rate of only 54.2% (p < 0.05).