Distinct Clinicopathological and Prognostic Features of Thin Nodular Primary Melanomas: An International Study from 17 Centers.
In: JNCI: Journal of the National Cancer Institute, Jg. 111 (2019-12-01), Heft 12, S. 1314-1322
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Zugriff:
Background: Nodular melanoma (NM) is more likely to be fatal compared with other melanoma subtypes, an effect attributed to its greater Breslow thickness. Methods: Clinicopathological features of NM and superficial spreading melanoma (SSM) diagnosed in 17 centers in Europe (n = 15), the United States, and Australia between 2006 and 2015, were analyzed by multivariable logistic regression analysis, with emphasis on thin (T1 ≤ 1.0 mm) melanomas. Cox analysis assessed melanoma-specific survival. All statistical tests were two sided. Results: In all, 20 132 melanomas (NM: 5062, SSM: 15 070) were included. Compared with T1 SSM, T1 NM was less likely to have regression (odds ratio [OR] = 0.46, 95% confidence interval [CI] = 0.29 to 0.72) or nevus remnants histologically (OR = 0.60, 95% CI = 0.42 to 0.85), and more likely to have mitoses (OR = 1.97, 95% CI = 1.33 to 2.93) and regional metastasis (OR = 1.77, 95% CI = 1.02 to 3.05). T1 NM had a higher mitotic rate than T1 SSM (adjusted geometric mean = 2.2, 95% CI = 1.9 to 2.5 vs 1.6, 95% CI = 1.5 to 1.7 per mm2, P < .001). Cox multivariable analysis showed a higher risk for melanoma-specific death for NM compared with SSM for T1 (HR = 2.10, 95% CI = 1.24 to 3.56) and T2 melanomas (HR = 1.30, 95% CI = 1.01 to 1.68), and after accounting for center heterogeneity, the difference was statistically significant only for T1 (HR = 2.20, 95% CI = 1.28 to 3.78). The NM subtype did not confer increased risk within each stratum (among localized tumors or cases with regional metastasis). Conclusions: T1 NM (compared with T1 SSM) was associated with a constellation of aggressive characteristics that may confer a worse prognosis. Our results indicate NM is a high-risk melanoma subtype that should be considered for inclusion in future prognostic classifications of melanoma. [ABSTRACT FROM AUTHOR]
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Distinct Clinicopathological and Prognostic Features of Thin Nodular Primary Melanomas: An International Study from 17 Centers.
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Autor/in / Beteiligte Person: | Dessinioti, Clio ; Dimou, Niki ; Geller, Alan C ; Stergiopoulou, Aravella ; Lo, Serigne ; Keim, Ulrike ; Gershenwald, Jeffrey E ; Haydu, Lauren E ; Ribero, Simone ; Quaglino, Pietro ; Puig, Susana ; Malvehy, Josep ; Kandolf-Sekulovic, Lidija ; Radevic, Tatjana ; Kaufmann, Roland ; Meister, Laura ; Nagore, Eduardo ; Traves, Victor ; Champsas, Grigorios G ; Plaka, Mihaela |
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Zeitschrift: | JNCI: Journal of the National Cancer Institute, Jg. 111 (2019-12-01), Heft 12, S. 1314-1322 |
Veröffentlichung: | 2019 |
Medientyp: | academicJournal |
ISSN: | 0027-8874 (print) |
DOI: | 10.1093/jnci/djz034 |
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