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Related Experiment Videos

Cutaneous melanomas that defy conventional prognostic indicators

W H McCarthy1, H M Shaw, S W McCarthy

  • 1Sydney Melanoma Unit, Royal Prince Alfred Hospital, University of Sydney, Australia.

Seminars in Oncology
|December 1, 1996
PubMed
Summary

Melanoma tumor thickness usually predicts prognosis, but some thin melanomas recur and thick ones have good survival. Long-term data reveals exceptions to standard prognostic indicators in melanoma patients.

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Area of Science:

  • Oncology
  • Dermatology
  • Pathology

Background:

  • Tumor thickness is a primary prognostic indicator for melanoma.
  • However, atypical cases of melanoma recurrence and survival exist, defying conventional predictions.
  • Long-term follow-up data is crucial for understanding these exceptions.

Purpose of the Study:

  • To investigate melanoma cases that do not align with established prognostic indicators.
  • To analyze long-term outcomes in a large cohort of melanoma patients.
  • To identify factors influencing unusual melanoma progression and survival.

Main Methods:

  • Analysis of a comprehensive 45-year database from the Sydney Melanoma Unit.
  • Inclusion of over 13,000 melanoma patients with long-term follow-up.

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  • Correlation of clinical and histological features with patient outcomes, including recurrence and survival.

    • Main Results:

    • 2.8% of stage I patients with thin melanomas (< 0.50 mm) experienced recurrence, more common in women, associated with ulceration and high mitotic activity.
    • 3.1% of patients with thin melanomas had concurrent lymph node metastases (stage III), predominantly in men with regressive lesions.
    • 15.7% of stage II/III patients with thick melanomas (> 5.5 mm) survived over 15 years; 1.7% of all patients relapsed after > 15 years disease-free interval.

    Conclusions:

    • Melanoma prognosis is complex, with thin and thick lesions sometimes exhibiting unexpected behavior.
    • Histological features traditionally used for prognosis were not consistently predictive in cases with exceptionally long survival or late relapse.
    • Further research is needed to refine prognostic models for melanoma, especially for atypical presentations.