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Histologic staging in malignant melanoma: cross-sectional area revisited
C F Temple1, S A Huchcroft, D J Hurlbut
1Queen's University and the Kingston Regional Cancer Centre, Ontario, Canada.
Journal of Surgical Oncology
|November 10, 1998
Summary
Cross-sectional area (CSA) is a simple measurement for malignant melanoma that predicts survival as accurately as tumor thickness. This finding suggests CSA could be a valuable prognostic tool for melanoma patients.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Tumor thickness is a key predictor of survival in malignant melanoma.
- Tumor volume is a more sensitive predictor but is complex to measure.
- This study evaluates cross-sectional area (CSA) as a simpler alternative prognostic indicator.
Purpose of the Study:
- To compare the prognostic power of cross-sectional area (CSA) with tumor thickness in malignant melanoma.
- To determine if CSA can serve as a reliable predictor of 5-year survival.
Main Methods:
- Retrospective analysis of 45 patients with localized malignant melanoma and at least 5-year follow-up.
- Digitalized histologic images were used to calculate maximum tumor thickness and CSA.
- Predictive accuracy of CSA and thickness for 5-year survival was compared.
Main Results:
- Cross-sectional area (CSA) showed a positive correlation with tumor thickness (r = 0.76).
- Both CSA and thickness demonstrated similar predictive accuracy for patient survival.
- Melanomas with CSA < 8 mm² had significantly better 5-year survival (94%) and disease-free survival (78%) rates compared to those > 8 mm².
Conclusions:
- Cross-sectional area (CSA) is an easily calculated measurement for malignant melanoma.
- CSA is as predictive for 5-year survival as Breslow's thickness.
- Prospective studies are recommended to further assess the clinical utility of CSA.