TITLE

Factors Associated with Death from Melanoma from 2 to 5 Years Following Diagnosis in Clinical Stage I Patients

AUTHOR(S)
Sober, Arthur J.; Day Jr., Calvin L.; Fitzpatrick, Thomas B.; Lew, Robert A.; Kopf, Alfred W.; Mihm Jr., Martin C.
PUB. DATE
June 1983
SOURCE
Journal of Investigative Dermatology;Jun83 Supplement, Vol. 80, p53s
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
We studied 14 prognostic factors in 428 patients with clinical stage I melanoma to determine which factor or combination of factors was associated with death from melanoma from 24 to 60 months following diagnosis. Forty-eight patients (11 percent) died during this period. All 17 patients who had visceral metastases present at 24 months died during this period. All surviving patients were followed for at least 60 months. Individual high risk factors included ulceration width (as determined by histology), level IV or V tumor, recurrence other than visceral, 6 or more mitoses per square millimeter, presence of involved nodes on elective dissection, absent or slight lymphocyte response, tumor type other than superficial spreading, location other than extremities (excluding hands and feet), microscopic satellites, thickness, sex, and wide local excision. The presence of sex as a risk factor for patients dying from 2 to 5 years following diagnosis is noteworthy because no sex difference was noted in the early death (<24 months) group. Age, presence of a nevus, and histologic regression were not significant factors. A logistic regression analysis selected a combination of the following independent factors: (1) location on extremities excluding hands and feet (favorable), (2) thickness, (3) recurrence other than visceral, (4) positive elective nodal dissection, (5) 6 or more mitoses per square millimeter, and (6) moderate to marked lymphocyte response (favorable). Twenty-five percent of patients with level IV lesions died between 24 and 60 months compared with only a 6 percent death rate within the first 24 months.
ACCESSION #
12537168

 

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