scholarly journals Breslow thickness and Clark level in melanoma

Cancer ◽  
2000 ◽  
Vol 88 (3) ◽  
pp. 589-595 ◽  
Author(s):  
Ashfaq A. Marghoob ◽  
Karen Koenig ◽  
Flavia V. Bittencourt ◽  
Alfred W. Kopf ◽  
Robert S. Bart
Keyword(s):  
Breslow Thickness ◽  
Clark Level

scholarly journals Immunohistochemical Analysis of BRAF (V600E) Mutation and P16 Expression in Malignant Melanoma in Lagos, Nigeria: A 10-Year Retrospective Study

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
O. Obadofin ◽  
K. Badmos ◽  
N. Orsi ◽  
M. Bipin ◽  
O. Rotimi ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Protein Expression ◽  
Immunohistochemical Analysis ◽  
Braf V600e Mutation ◽  
Breslow Thickness ◽  
University Teaching ◽  
Braf V600e ◽  
Clark Level ◽  
P16 Protein ◽  
P16 Expression

Background. In Blacks, malignant melanoma (MM) is associated with greater morbidity and mortality compared to Caucasians. MMs with BRAF V600E mutation as well as those with loss of p16 protein expression are associated with aggressive behavior and worse prognosis. Objectives. We determined BRAF (V600E) mutation status and loss of p16 expression in MM cases in Lagos, Nigeria, and correlated these with histopathologic parameters and patients’ age. Methods. Forty-five cases of MM received between January 2005 and December 2014 in the Anatomic and Molecular Pathology Department of Lagos University Teaching Hospital were subjected to immunohistochemical studies to determine BRAF V600E mutation and p16 protein expression. These included cutaneous (n=37), musosal (n=3), and ocular MM (n=2) as well as lymph node metastatases (n=3). Results. BRAF (V600E) mutations were detected in 5/45 (11%) while 31/45 (69%) of the cases had loss of p16 expression. No statistically significant association was found between the BRAF (V600E) mutation, loss of p16 expression, and histologic parameters such as histologic variant, Clark level, Breslow thickness, and ulceration. Conclusion. BRAF (V600E) mutation was detected only in a small proportion of cases while loss of p16 expression occurred in most cases which also had high Clark level, high Breslow thickness, and ulceration.

Multivariate analysis of the relationship between survival and the microstage of primary melanoma by clark level and breslow thickness

Cancer ◽  
1993 ◽  
Vol 71 (11) ◽  
pp. 3737-3743 ◽  
Author(s):  
Donald L. Morton ◽  
David G. Davtyan ◽  
Leslie A. Wanek ◽  
Leland J. Foshag ◽  
Alistar J. Cochran
Keyword(s):  
Multivariate Analysis ◽  
Primary Melanoma ◽  
Breslow Thickness ◽  
Clark Level ◽  
The Relationship

Prognostic significance of children with cutaneous melanoma: Implications for treatment

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8021-8021
Author(s):  
M. A. Kavanagh ◽  
R. Essner ◽  
S. L. Chen ◽  
L. A. Wanek ◽  
R. P. Scheri ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cutaneous Melanoma ◽  
Pediatric Patients ◽  
Prognostic Significance ◽  
Initial Diagnosis ◽  
Adult Patients ◽  
Breslow Thickness ◽  
Superficial Spreading ◽  
Clark Level ◽  
Melanoma Patients

8021 Background: The incidence of melanoma in pediatric patients, particularly teenagers, is increasing. Treatment strategies employed for adult patients with melanoma have been applied to pediatric populations with minimal data to support similar efficacy. We performed a matched-paired analysis to compare the prognosis of pediatric (≤19 yrs old) and adult melanoma patients. Methods: Single institution, prospectively obtained melanoma database containing >14,000 records was queried for children ages 1–19 years treated for cutaneous melanoma. We identified 197 pediatric patients seen at our institute over the last 35 years. After excluding patients not seen within 4 months of initial diagnosis, 115 pediatric patients were matched to adults (age 20–70 years) chosen from the database by gender, stage, primary site and tumor characteristics (Clark level, Breslow thickness, and ulceration). Overall survival was compared between cohorts by the Kaplan-Meier method. Results: For the pediatric patients, median age at diagnosis was 17.7 years (range 7–19 years). Patients were almost equally distributed between girls (47%) and boys. AJCC stage I and II disease at presentation was most common (73%), with stage III and IV occurring much less frequently (25% and 2%). Most pediatric patients had Clark level IV (37%) lesions; Clark level II (25%), III (25%), V (4%), and I (2%) lesions were less common. Breslow thickness ranged between <1.0mm (38%), 1.1–2.0mm (20%), 2.1–4.0mm (17%), and >4.1mm (12%). The two predominant histologic types were superficial spreading (52%) and nodular (22%) melanoma. 14% of the primary lesions were ulcerated. Rates of disease-free and overall survival were 75%± 4% and 84%± 4% at 5 years and 74%± 4% and 77%± 5% at 10 years, respectively, with a median follow up of 5.1 years (range 1–30 years). Matched pediatric and adult patients showed no difference in survival from time of initial diagnosis and stage of presentation (log rank p=0.24). Conclusions: Stage-specific survival in pediatric and adult melanoma patients is similar. In the absence of specific pediatric trials, standard treatment for children with melanoma should be consistent with that for adults. No significant financial relationships to disclose.

Second primary melanoma: Risk factors, histopathologic features, and survival

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9073-9073
Author(s):  
H. F. Schoellhammer ◽  
H. Torisu-Itakura ◽  
Y. Huynh ◽  
M. Sim ◽  
M. B. Faries ◽  
...  
Keyword(s):  
Primary Melanoma ◽  
Breslow Thickness ◽  
Second Primary ◽  
Clark Level ◽  
Ajcc Stage ◽  
Melanoma Patients ◽  
Level I ◽  
Second Primaries

9073 Background: Melanoma incidence in the United States is expected to be 4.3% of all cancers in 2008. Cutaneous melanoma patients are at risk for second primary melanoma development. Our goal was to characterize the histopathologic features, risk factors, and patient survival for second primary melanoma. Methods: A review of the melanoma database established in 1971 at John Wayne Cancer Institute was conducted identifying patients with American Joint Committee on Cancer (AJCC) stage I and II cutaneous melanoma who later developed a second primary melanoma. Patients were grouped by Breslow thickness, Clark level, and histopathologic subtype (superficial spreading [SSM], nodular, acral lentiginous, lentigo maligna, and in situ). Multivariate analysis involving age, gender, Breslow thickness, Clark level, and ulceration status was performed to determine an effect on development of second primary. Kaplan-Meier survival curves were plotted for single primary and second primary melanoma patients. Results: Second primary melanoma was identified in 411 (3.7%) of 10,968 patients with AJCC stage I-II melanoma. The most common first primary subtype was SSM, and 93% of these patients had in situ or SSM as the second primary. Sixty-five percent of first primaries had a Breslow thickness of ≤1 mm, and 75% of second primaries had a thickness ≤1 mm. Forty-nine percent of first primaries had Clark level I or II, but 68% of second primaries had Clark level I or II. In multivariate analysis, only increasing age was significantly associated with the likelihood of second primary melanoma (p<0.0001). With increasing follow-up time the hazard ratio of second primary melanoma was 1.31 for every decade. Overall survival for second primary melanoma patients was better than for single primary patients (p<0.0001). Conclusions: Most second primary melanoma patients will have SSM or in situ, with a decreased Clark level and Breslow thickness. Contrary to expectations, patients developing second primary melanoma did not exhibit decreased overall survival. Increased follow-up time after first primary melanoma is a significant risk factor for second primary development, thus illustrating the importance of lifelong patient follow-up. No significant financial relationships to disclose.

scholarly journals Indications of Sentinel Node Biopsy in Thin Melanoma

2010 ◽  
Vol 8 (2) ◽  
pp. 235-240 ◽  
Author(s):  
Fernanda Braga Silva ◽  
Renato Santos de Oliveira Filho ◽  
Wagner Iared ◽  
Álvaro Nagib Atallah ◽  
Ivan Dunchee de Abranches Oliveira Santos ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Breslow Thickness ◽  
Cochrane Library ◽  
Clark Level ◽  
Thin Melanoma ◽  
Risk Of Death ◽  
Node Biopsy ◽  
Histological Factors ◽  
Mitosis Rate

ABSTRACT Objective: To assess data on survival, recurrence and histological factors in positive and negative sentinel lymph nodes in thin melanoma cases. Methods: A systematic review was conducted on observational studies in four databases (Cochrane Library, Medline, Embase and Lilacs). Positive and negative micrometastases in sentinel lymph node biopsy were compared regarding the clinical outcomes – death and recurrence – and six histological factors – vertical growth phase, Breslow thickness, Clark level, ulceration, regression and mitosis rate. Results: Positive sentinel lymph node is statistically associated with greater risk of death in six studies (OR: 7.2; 95%CI [2.37-21.83]; I2 0%) and also to recurrence in three studies (OR: 30.7; 95%CI [12.58-74.92]; I2 36%). Comparing positive and negative groups, the histological factors predicting positive sentinel nodes and poor prognosis were: mitosis rate ≥ 5/mm2 (OR: 16.29; 95%CI [3.64-72.84]; I2 40%); VGP (OR: 2.93; 95%CI [1.08-7.93]; I2 59%); Breslow thickness ≥ 0.75mm (OR: 2.23; 95%CI [1.29-3.86]; I2 0%); and Clark level IV-V (OR: 1.61; 95%CI [1.06-2.44]; I2 34%). Conclusions: The statistically significant results associated with the presence of micrometastases in thin melanomas were Breslow thickness ≥ 0.75 mm, Clark level IV-V and mitoses ≥ 5/mm2, absence of regression. This histological factor of ulceration was associated, but not statistically significant.

Clinicopathologic Predictors of Sentinel Lymph Node Metastasis in Thin Melanoma

2013 ◽  
Vol 31 (35) ◽  
pp. 4387-4393 ◽  
Author(s):  
Dale Han ◽  
Jonathan S. Zager ◽  
Yu Shyr ◽  
Heidi Chen ◽  
Lynne D. Berry ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Multivariable Analysis ◽  
Mitotic Rate ◽  
Lymph Node Biopsy ◽  
Breslow Thickness ◽  
Clinicopathologic Characteristics ◽  
Clark Level ◽  
Thin Melanoma

PurposeIndications for sentinel lymph node biopsy (SLNB) for thin melanoma are continually evolving. We present a large multi-institutional study to determine factors predictive of sentinel lymph node (SLN) metastasis in thin melanoma.Patients and MethodsRetrospective review of the Sentinel Lymph Node Working Group database from 1994 to 2012 identified 1,250 patients who had an SLNB and thin melanomas (≤ 1 mm). Clinicopathologic characteristics were correlated with SLN status and outcome.ResultsSLN metastases were detected in 65 (5.2%) of 1,250 patients. On univariable analysis, rates of Breslow thickness ≥ 0.75 mm, Clark level ≥ IV, ulceration, and absence of regression differed significantly between positive and negative SLN groups (all P < .05). These four variables and mitotic rate were used in multivariable analysis, which demonstrated that Breslow thickness ≥ 0.75 mm (P = .03), Clark level ≥ IV (P = .05), and ulceration (P = .01) significantly predicted SLN metastasis with 6.3%, 7.0%, and 11.6% of the patients with these respective characteristics having SLN disease. Melanomas < 0.75 mm had positive SLN rates of < 5% regardless of Clark level and ulceration status. Median follow-up was 2.6 years. Melanoma-specific survival was significantly worse for patients with positive versus negative SLNs (P = .001).ConclusionBreslow thickness ≥ 0.75 mm, Clark level ≥ IV, and ulceration significantly predict SLN disease in thin melanoma. Most SLN metastases (86.2%) occur in melanomas ≥ 0.75 mm, with 6.3% of these patients having SLN disease, whereas in melanomas < 0.75 mm, SLN metastasis rates are < 5%. By using a 5% metastasis risk threshold, SLNB is indicated for melanomas ≥ 0.75 mm, but further study is needed to define indications for SLNB in melanomas < 0.75 mm.

Tumor Thickness and Modified Clark Level in Canine Cutaneous Melanocytic Tumors

2018 ◽  
Vol 56 (2) ◽  
pp. 180-188 ◽  
Author(s):  
Serenella Silvestri ◽  
Ilaria Porcellato ◽  
Luca Mechelli ◽  
Laura Menchetti ◽  
Sofia Rapastella ◽  
...  
Keyword(s):  
Prognostic Significance ◽  
Tumor Thickness ◽  
Histological Diagnosis ◽  
Breslow Thickness ◽  
Sample Population ◽  
Clark Level ◽  
Melanocytic Tumors ◽  
Level Of Invasion ◽  
Ocular Micrometer ◽  
Invasive Cell

Breslow thickness and Clark level are prognostic factors for human cutaneous melanomas. Breslow thickness is measured with an ocular micrometer from the top of the granular layer of the epidermis to the deepest invasive cell across the broad base of the tumor, while Clark level is based on the anatomical level of invasion through the layers of the dermis. Because of the anatomical differences between humans and dogs, we evaluated the tumor thickness and a modified Clark level in 77 canine primary cutaneous melanocytic tumors. Tumor thickness (using both a traditional and a more convenient system) and modified Clark level were measured and associated with histological diagnosis and clinical outcome. Tumor thickness was a prognostic factor, being greater in animals with shorter overall survival and disease-free time. Cutoffs of 0.95 cm and 0.75 cm defined a higher hazard for an unfavorable outcome and to develop recurrence/metastasis, respectively. Because of an excellent agreement between the 2 methods, it was concluded that tumor thickness could be measured with a ruler when an ocular micrometer is not available. Modified Clark level was not found to be relevant for prognosis. However, we suggest that both tumor thickness and a modified Clark level can be valid additional parameters when histological diagnosis is uncertain. Further studies, including a wider sample population, would be worthwhile to confirm the prognostic significance of these 2 parameters.

Clark Level IV

2020 ◽  
Author(s):  
Keyword(s):  
Clark Level
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