Outcomes and prognostic factors in superficial spreading melanoma

Am J Surg. 2013 Dec;206(6):861-7; discussion 867-8. doi: 10.1016/j.amjsurg.2013.09.003. Epub 2013 Oct 1.

Abstract

Background: Prognostic factors and risk factors for positive sentinel lymph node (SLN) biopsy results are important to identify in superficial spreading melanoma (SSM).

Methods: A single-center database and a prospective clinical trial database were reviewed for all patients with diagnoses of SSM. Logistic regression, Kaplan-Meier survival analysis, and univariate and multivariate Cox models were used.

Results: A total of 1,643 patients with SSM were identified. Independent risk factors for positive SLN biopsy results were Breslow thickness (BT) ≥2.0 mm, age <60 years, and presence of ulceration. BT ≥2.0 mm, ulceration, lymphovascular invasion, and positive SLN and positive non-SLN biopsy results were independent risk factors for worse disease-free survival. Independent overall survival risk factors included BT ≥2.0 mm, age ≥60 years, ulceration, nonextremity tumor location, lymphovascular invasion, and positive SLN biopsy results.

Conclusions: BT, ulceration, lymphovascular invasion, and SLN and non-SLN status are important risk factors for SSM.

Keywords: Lymphovascular invasion; Melanoma histology; Melanoma prognosis; Nonsentinel lymph node melanoma; Sentinel lymph node biopsy melanoma; Superficial spreading melanoma.

Publication types

  • Comparative Study

MeSH terms

  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Male
  • Melanoma / diagnosis
  • Melanoma / mortality
  • Melanoma / secondary*
  • Melanoma, Cutaneous Malignant
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Sentinel Lymph Node Biopsy / methods*
  • Skin Neoplasms
  • United States / epidemiology