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Histopathologic study of recurrent Clark level II melanomas
L F Glass1, J M Guffey, K R Schroer
1Department of Internal Medicine, H. Lee Moffitt Cancer Center and Research Institute, James A. Haley Veterans' Hospital, University of South Florida College of Medicine, Tampa 33612.
Seminars in Surgical Oncology
|May 1, 1993
Summary
Thin melanoma prognosis is generally excellent, but some patients experience recurrence. Breslow thickness over 0.4 mm is linked to shorter disease-free intervals in these cases.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Thin melanoma (less than 0.76 mm) typically has an excellent prognosis.
- However, unexpected recurrences in patients with thin melanoma lesions have been reported.
Purpose of the Study:
- To investigate histopathologic features of recurrent Clark level II melanoma.
- To compare these features with non-recurrent lesions to identify prognostic indicators.
Main Methods:
- Histologic sections from eight recurrent Clark level II melanoma cases were compared to eight non-recurrent cases.
- Evaluated prognostic variables included Breslow thickness, mitotic rate, ulceration, regression, vertical growth phase, and associated banal nevus.
- Evaluation was performed in a double-blind manner.
Main Results:
- Breslow thickness was the only statistically significant predictor of outcome (P = 0.04).
- A Breslow thickness greater than 0.4 mm correlated with a significantly shorter disease-free interval.
- Histologic features did not reliably predict recurrence (P = 0.36).
Conclusions:
- While prognostic models for melanoma are generally reliable, some thin melanomas have a worse outcome than expected.
- Breslow thickness is a key factor, but other histologic features may not accurately predict recurrence in thin melanomas.