Clinico-pathological Study of Malignant Melanoma in A Tertiary Care Centre

Introduction: Malignant melanoma, which causes three fourth of all deaths related to skin cancer, is more common in Caucasian population compared to Asian population. There is no reliable information about malignant melanoma in Nepal hence an effort has been made to assess the clinical and pathological features of melanoma patients. Methods: This was a retrospective hospital based study done in the department of Pathology. All cases of malignant melanoma diagnosed on biopsy during a period of 13 years were retrieved, reviewed and collated. Results: We had 35 cases with age range from 15 to 84 years with the mean of 51.4 years and M: F of 1.3:1. The predominant site was lower extremities. Most cases were less than 3 cm. Majority of histologic subtypes were nodular melanoma 29 (82.8%) followed by mucosal lentiginous melanoma 3 (8.6%), superficial spreading melanoma 2 (5.7%) and acral lentiginous melanoma 1 (2.9%). Half (50%) of the excisional biopsies were at Clark’s level IV and 75% were at high Breslow thickness. Conclusions: The most frequent site in males and females were lower extremities and trunk respectively in contrast to Western studies where it is opposite. Nodular melanoma was the commonest histologic subtype while in other Asian studies and in Western studies majority were acral lentiginous melanoma and superficial spreading melanoma respectively. Keywords: Breslow thickness; Clark’s level; malignant melanoma; nodular melanoma.

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Tyrosinase activity in three types of the malignant melanoma: Superficial spreading melanoma, mentigo maligna melanoma and Nodular Melanoma

Archives of Dermatological Research ◽

10.1007/bf00557919 ◽

1975 ◽

Vol 252 (3) ◽

pp. 193-201 ◽

Cited By ~ 6

Author(s):

Rudolf Haensch

Keyword(s):

Malignant Melanoma ◽

Tyrosinase Activity ◽

Superficial Spreading ◽

Superficial Spreading Melanoma ◽

Nodular Melanoma

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Regression Does Not Predict Nodal Metastasis or Survival in Patients with Cutaneous Melanoma

The American Surgeon ◽

10.1177/000313481107700819 ◽

2011 ◽

Vol 77 (8) ◽

pp. 1009-1013 ◽

Cited By ~ 12

Author(s):

Alison L. Burton ◽

Juliana Gilbert ◽

Russell W. Farmer ◽

Arnold J. Stromberg ◽

Lee Hagendoorn ◽

...

Keyword(s):

Multivariate Analysis ◽

Cutaneous Melanoma ◽

Clinical Decision Making ◽

Univariate Analysis ◽

Disease Free Survival ◽

Nodal Metastasis ◽

Breslow Thickness ◽

Significant Prognostic Factor ◽

Superficial Spreading ◽

Histologic Subtype

Controversy exists regarding the prognostic implications of regression in patients with cutaneous melanoma. Some consider regression to be an indication for sentinel lymph node (SLN) biopsy because regression may result in underestimation of the true Breslow thickness. Other data support regression as a favorable prognostic indicator, representing immune system recognition of the primary tumor. This analysis was performed to determine whether regression predicts nodal metastasis, disease-free survival (DFS), or overall survival (OS). Post hoc analysis was performed of a multicenter prospective randomized trial that included patients aged 18 to 70 years with cutaneous melanomas 1 mm or greater Breslow thickness. All patients underwent SLN biopsy; those with tumor-positive SLN underwent completion lymphadenectomy. Kaplan-Meier analysis of survival, univariate analysis, and multivariate analysis were performed. A total of 2220 patients (261 with regression; 1959 without regression) were included in this analysis with a median follow-up of 68 months. Patients with regression were more likely to be male, older than 50 years old, and have lower median Breslow thickness, superficial spreading histologic subtype, and a non-extremity anatomic location ( P < 0.05 in all cases). Regression was not significantly associated with Clark level, ulceration, lymphovascular invasion, number of SLNs removed, or SLN metastasis. On multivariate analysis, factors independently predictive of DFS included Breslow thickness, ulceration, and SLN status ( P < 0.05 in all cases); the same factors along with age, gender, and anatomic tumor location were significantly associated with OS ( P < 0.05 in all cases). Regression was not significantly associated with DFS (risk ratio [RR], 0.94; 95% confidence interval [CI], 0.67-1.27; P = 0.68) or OS (RR, 1.01; 95% CI, 0.76-1.32; P = 0.93). These data suggest that regression is not a significant prognostic factor for patients with cutaneous melanoma and should not be used to guide clinical decision-making for such patients.

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Different clinical behavior of nodular melanoma (NM) compared to superficial spreading melanoma (SSM) at New York University from 1972 to present

Journal of Clinical Oncology ◽

10.1200/jco.2008.26.15_suppl.20001 ◽

2008 ◽

Vol 26 (15_suppl) ◽

pp. 20001-20001

Author(s):

M. A. Warycha ◽

J. Z. Yu ◽

P. Christos ◽

F. Darvishian ◽

H. Kamino ◽

...

Keyword(s):

New York ◽

New York University ◽

Superficial Spreading ◽

Clinical Behavior ◽

Superficial Spreading Melanoma ◽

Nodular Melanoma

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Prognosis of melanoma in Peru: An analysis of 410 cases.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e20023 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e20023-e20023

Author(s):

Natalia Coras ◽

Domingo Morales ◽

Alejandro Yabar ◽

Brady Ernesto Beltran

Keyword(s):

Malignant Melanoma ◽

Clinical Stage ◽

Univariate Analysis ◽

Survival Rates ◽

Retrospective Chart Review ◽

Stage I ◽

Unknown Primary ◽

Superficial Spreading ◽

Acral Lentiginous Melanoma ◽

Female Ratio

e20023 Background: Little is known of the status of melanoma in developing countries. Our retrospective study was performed to determine the clinical characteristics and outcome of patients with melanoma in Peru. Methods: All cases with a pathological diagnosis of malignant melanoma from our institution between January 2002 and December 2011 were identified. Clinical data were extracted through retrospective chart review. Patients’ characteristics are presented using descriptive statistics. Survival curves were estimated using the Kaplan-Meier method. Univariate and multivariate analyses were evaluated using log-rank and Cox proportional-hazard regression tests, respectively. Results: A total of 410 cases were evaluated. The median age at presentation was 66 years (range 4-97 years) with a male-to-female ratio was 1.1:1. There were 146 cases (35.6%) of acral lentiginous melanoma, 67 (16.3%) of nodular melanoma, 54 (16.3%) of mucosal melanoma, 39 (9.5%) of superficial spreading melanoma, 55 (13.4%) were lentigo maligno and 49 (12.0%) were unclassifiable. Melanoma of unknown primary occurred in 34 (8.3%) of cases. The proportion of patients with stage I, II, III and IV disease were 24.2%, 24.8%, 21.9% and 7.8%, respectively. Ulceration status of 320 cases of cutaneous melanoma was recorded and 138 (45.1%) had ulceration. The 5-year survival rate of 409 patients was 58.4% with a median survival time of 7.6 years. The 5-year survival rates of patients with stage I, II, III and IV disease were 88.2%, 67.8%, 39.3% and 17.8% respectively (p<0.001). Univariate analysis showed age >65 years (p=0.003), male sex (p=0.0001), stage (p<0.001), nodular histology type (p<0.001), ulceration (p<0.001), Breslow thickness (p<0.001), Clark level (p<0.001) and localization (mucosal vs. cutaneous) (p<0.001) were associated with survival. In the multivariate analysis, stage was associated with worst prognosis (p=0.01), while other factors had no statistical correlation with survival. Conclusions: Based on our report, acral lentiginous melanoma is the most common type of malignant melanoma in Peruvian patients, and clinical stage was the only independent prognostic factor associated with survival.

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Is superficial spreading melanoma still the most common form of malignant melanoma?

Journal of the American Academy of Dermatology ◽

10.1016/j.jaad.2007.10.650 ◽

2008 ◽

Vol 58 (6) ◽

pp. 1013-1020 ◽

Cited By ~ 42

Author(s):

Seth B. Forman ◽

Tammie C. Ferringer ◽

Steven J. Peckham ◽

Scott R. Dalton ◽

Geoff T. Sasaki ◽

...

Keyword(s):

Malignant Melanoma ◽

Superficial Spreading ◽

Superficial Spreading Melanoma

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Caucasians with acral lentiginous melanoma have the same outcome as patients with stage- and limb-matched superficial spreading melanoma

Journal of Cancer Research and Clinical Oncology ◽

10.1007/s00432-021-03630-6 ◽

2021 ◽

Author(s):

Laura Susok ◽

Thilo Gambichler

Keyword(s):

Prognostic Factors ◽

Positive Sentinel Lymph Node ◽

Clinical Findings ◽

Disease Relapse ◽

Superficial Spreading ◽

Significant Independent Predictor ◽

Acral Lentiginous Melanoma ◽

Superficial Spreading Melanoma ◽

Delay In Diagnosis

Abstract Purpose Acral lentiginous melanoma (ALM), a relatively rare subtype of cutaneous melanoma, has been reported to have a worse prognosis than other melanomas. We aimed to assess clinical findings in Caucasian ALM patients and compare the data with a matched cohort of superficial spreading melanoma (SSM) patients. Methods We studied 63 patients with ALM and 63 randomly stage- and limb-matched patients with SSM (non-ALM). In both cohorts, guideline-adjusted diagnosis, treatment and follow-up were performed. Results We did not observe differences in prognostic factors (e.g., tumor thickness, ulceration) between the two cohorts. Both in ALM and non-ALM patients positive sentinel lymph node was a significant independent predictor for disease relapse and melanoma-specific death. However, disease relapse and melanoma-specific death rates did not significantly differ between ALM and non-ALM patients. An overall 5-year melanoma-specific survival of 82.5% and 81% was observed in ALM and non-ALM patients, respectively. Conclusions Our data confirm that patients with ALM have no worse outcome than non-ALM patients when correcting for significant prognostic factors. Hence, the reportedly high rates of fatal ALM cases should not be ascribed to pathobiological differences between ALM and non-ALM but are most likely are a consequence of a delay in diagnosis and thus advanced stage of ALM.

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Activity of Skin Cancer Clinic at Martin University Hospital in 2017

Acta Medica Martiniana ◽

10.2478/acm-2018-0003 ◽

2018 ◽

Vol 18 (1) ◽

pp. 21-29

Author(s):

E Minarikova ◽

M Smolarova ◽

M Minarik

Keyword(s):

Skin Cancer ◽

Malignant Melanoma ◽

Skin Lesions ◽

Common Type ◽

Upper Extremities ◽

Breslow Thickness ◽

University Hospital ◽

Superficial Spreading ◽

The University ◽

Cancer Clinic

Abstract The authors present new cases of malignant melanoma seen at the Skin Cancer Clinic of the University Hospital in Martin in the year 2017. There have been 112 new cases of malignant melanoma, 66 in men and 46 in women, diagnosed in 2017. We have recorded a occurence of two melanomas in one person in 3 patients, two men and one women. One patient had metastatic melanoma found in lymph nodes without corresponding skin lesions. The most common tumor body localisation in both men and women was on the back (51 melanomas, 45 %). In women, the most common localisation was upper extremities (13 melanomas, 29 %), followed by lower extremities and the back at the same rate (11 melanomas, 24 %). In men, the most common localisation was on the back (40 melanomas, 60 %). Histologically, the most common type was superficial spreading malignant melanoma (50 melanomas), the second most common was non specific type of malignant melanoma (19 melanomas). The majority of cases were low risk lesions with histological Breslow thickness in the range from 0,1 mm to 1 mm (47 melanomas). High risk lesions with histological Breslow thickness more than 4 mm were the second most common type (24 melanomas).

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