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Related Experiment Videos

Histologic regression in malignant melanoma: an interobserver concordance study

S Kang1, R L Barnhill, M C Mihm

  • 1Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston.

Journal of Cutaneous Pathology
|April 1, 1993
PubMed
Summary

Histologic regression in melanoma is difficult to consistently identify. A study found that while presence or absence of regression was highly agreed upon, staging regression was impractical.

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Area of Science:

  • Dermatopathology
  • Oncology
  • Histology

Background:

  • Histologic evidence of regression in melanoma has yielded conflicting prognostic results.
  • The consistency of identifying melanoma regression as a histologic feature requires further investigation.

Purpose of the Study:

  • To assess the interobserver concordance in identifying melanoma regression.
  • To determine if subdividing regression into stages impacts identification consistency.

Main Methods:

  • Fifty melanoma histologic slides (Breslow thickness ≤ 1 mm) were evaluated by two independent dermatopathologists.
  • Evaluators assessed regression in a bracketed area and the remaining tissue, referencing defined criteria.
  • Interobserver agreement was calculated for the presence/absence and staged regression.

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Main Results:

  • Overall concordance for presence/absence of regression was high (96% in bracketed area, 90% outside).
  • Interobserver agreement decreased significantly when regression was subdivided into stages (86% bracketed, 66% outside).
  • In 30% of cases, multiple regression stages were observed in non-bracketed areas.

Conclusions:

  • Consistent identification of melanoma regression requires a simple, systematic approach.
  • Subdividing regression into stages is impractical and may hinder consistent histologic assessment.
  • Future studies on melanoma prognosis should employ standardized methods for identifying regression.