Abstract
While it is not difficult to ascertain the prognosis for patients with metastatic melanoma, the outcome of the majority of patients with clinically localized melanoma is far less clearly defined. Prognostic variables help make rationale patient care decisions and guides the design and evaluation of clinical trials. Determining the prognosis of a patient with a diagnosis of melanoma is an evolving field. Prognostic criteria, once limited to clinical characteristics, have been augmented by a better understanding of melanoma histology and sentinel lymph node status. Investigation of lymph node and circulating melanoma antigens by reverse transcription polymerase chain reaction (RT-PCR) may further clarify a patient’ s prognosis.
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References
Reintgen DS, Paull DE, Seigler HF, et al. Sex related survival differences in instances of melanoma. Surg Gynecol Obstet 1984; 159: 367–372.
Shaw HM, McGovern VJ, Milton GW, et al. Histologic features of tumors and the female superiority in survival from malignant melanoma. Cancer 1980; 45: 1604–1608.
Shaw HM, McGovern VJ, Milton GW, et al. Malignant melanoma: influence of site of lesion and age of patient in the female superiority in survival. Cancer 1980; 46: 2731–2735.
Shaw HM, McCarthy WH, Milton GW. Melanoma: differing clinical patterns in older men and women. Geriatr Med Today 1985; 4: 31–43.
O’Doherty CJ, Prescott RI, White H, et al. Sex differences in presentation of cutaneous malignant melanoma and in survival from stage I disease. Cancer 1986; 58: 788–792.
Meyskens FL, Berdeaux DH, Parks B, et al. Cutaneous malignant melanoma (Arizona Cancer Center experience): I Natural history and prognostic factors influencing survival in patients with stage I disease. Cancer 1988; 62: 1207–1214.
Berdeaux DH, Meyskens FL, Parks B, et al. Cutaneous malignant melanoma. II The natural history and prognostic factors influencing the development of stage II disease. Cancer 1989; 63: 1430–1436.
Stadelman WK, Raport DR, Soong SJ, et al. Prognostic clinical and pathologic features. In: Balch CM, Houghton AN, Sober AJ, Soong SJ, eds., Cutaneous Melanoma, 3rd ed., Quality Medical Publishing, St. Louis, MO, 1998.
Dong XD, Tyler D, Johnson JL, DeMatos P, Seigler HF. Analysis of prognosis and disease progression after local recurrence of melanoma. Cancer 2000; 88: 1063–1071.
Sirott MN, Bajorin DF, Wong GC, et al. Prognostic factors in patients with metastatic malignant melanoma. Cancer 1993; 72: 3091–3098.
Blois MS, Sagebiel RW, Tuttle MS, et al. Judging prognosis in malignant melanoma of the skin. Ann Surg 1983; 198: 200–206.
Sondergaard, K, Schou G. Therapeutic and clinico-pathological factors in the survival of 1,469 patients with primary cutaneous malignant melanoma in clinical stage I. Virchows Arch (Pathol Anat) 1985; 408: 249–258.
Johnson OK, Emrich LJ, Karakousis CP, et al. Comparison of prognostic factors for survival and recurrence in malignant melanoma of the skin clinical stage I. Cancer 1985; 55: 1107–1117.
Karjalainen S, Hakulin T. Survival and prognostic factors of patients with skin melanoma. Cancer 1988; 62: 2274–2280.
Schuchter L, Schultz DJ, Synnestvedt M, et al. A prognostic model for predicting 10-year survival in patients with primary melanoma. Ann Intern Med 1996; 125: 369–375.
Sober AJ, Day CL, Fitzpatrick TB, et al. Early death from clinical stage I melanoma. JInvest Dermatol 1983; 80: 505–525.
Barnhill RL, Fine JA, Rousch GC, et al. Predicting five-year outcome for patients with cutaneous melanoma in a population-based study. Cancer 1996; 78: 427–432.
Balch CM, Soong SJ, Bartolucci AA, et al. Efficacy of an elective regional lymph node dissection of 1 to 4 mm thick melanomas for patients 60 years of age and younger. Ann Surg 1996; 224: 255–266.
Huang X, Soong SJ, McCarthy WH, et al. Classification of localized melanoma by the exponential survival trees method. Cancer 1997; 79: 1122–1128.
Day CL JR, Sober AJ, Kopf AW, et al. A prognostic model for clinical stage I melanoma of the upper extremity: the importance of anatomic subsites in predicting recurrent disease. Ann Surg 1981; 193: 436–440.
Bernengo MG, Reali UM, Doveil GC, et al. BANS: a discussion of the problem. Melanoma Res 1992; 2: 157–162.
Cascinelli N, Vaglini M, Bufalino R, et al. BANS: a cutaneous region with no prognostic significance in patients with melanoma. Cancer 1986; 57: 441–444.
Woods JE, Taylor WF, Pritchard DJ, et al. Is the BANS concept for malignant melanoma valid? Am J Surg 1985; 150: 452–455.
Rogers GS, Kopf AW, Rigel DS, et al. Influence of anatomic location on prognosis of malignant melanoma: attempt to verify the BANS model. J Am Acad Dermatol 1986; 15: 231–237.
Weinstock MA, Morris BT, Lederman JS, et al. Effects of BANS location of clinical Stage I melanoma: new data and meta-analysis. Br J Dermatol 1988; 119: 559–565.
Garbe C, Buttner P, Bertz J, et al. Primary cutaneous melanoma. Prognostic classification of anatomic location. Cancer 1995; 75: 2492–2498.
Balch CM, Soong S, Ross MI, et al. Long term results of a multi-institutional randomized trial comparing prognostic factors and surgical results for intermediate thickness melanomas (1.0 to 4.0mm). Ann Surg Oncol 2000; 7: 87–97.
Ragnarsson-Olding, BK, Nilsson BR, Kanter-Lewensohn LR, et al. Malignant melanoma of the vulva in a nationwide, 25-year study of 219 Swedish females. Cancer 1999; 96: 1285–1293.
Milton GW, Shaw HM. Rare variants of malignant melanoma. World Surg 1992; 16: 173–178.
Kilpatrick SE, White WL, Browne JD. Desmoplastic malignant melanoma of the oral mucosa. An underrecognized diagnostic pitfall. Cancer 1996; 78: 383–389.
Talley LI, Soong SJ, Harrison RA, et al. Clinical outcomes of localized melanoma of the foot: a case control study. J Clin Epidemiol 1998; 51: 853–857.
Reintgen DS, Vollmer R, Seigler HF. Juvenile malignant melanoma. Surg Gynecol Obstet 1989; 168: 249–253.
Cohen HJ, Cox E, Manton K, et al. Malignant melanoma in the elderly. J Clin Oncol 1987; 5: 100–106.
Austin PF, Cruse CW, Lyman G, et al. Age as a prognostic factor in the malignant melanoma population. Ann Surg Oncol 1994; 1: 487–494.
Balch CM, Soong S, Ross MI, et al. Long term results of a multi-institutional randomized trial comparing prognostic factors and surgical results for intermediate thickness melanomas (1.0 to 4.0 mm). Ann Surg Oncol 2000; 7: 87–97.
Sober Ai, Day CL, Fitzpatrick TB, et al. Early death from clinical stage I melanoma. J Invest Dermatol 1983; 80: 505–525.
Barnhill RL, Fine JA, Rousch GC, et al. Predicting five-year outcome for patients with cutaneous melanoma in a population-based study. Cancer 1996; 78: 427–432.
Shaw HM, McCarthy WH, Milton GW. Melanoma: Differing clinical patterns in older men and women. Geriatr Med Today 1985; 4: 31–43.
Falkson CI, Falkson HC. Prognostic factors in metastatic malignant melanoma. Oncology 1998; 55: 59–64.
Hena MA, Emrich LJ, Nabisan RN, et al. Effect of surgical treatment on stage IV melanoma. Am J Surg 1987; 153: 270–275.
McGovern VJ, Shaw HM, Milton GW, et al. Prognostic significance of the histological features of malignant melanoma. Histopathology 1979; 3: 385–393.
Garbe CG, Buttner P, Bertz J, et al. Primary cutaneous melanoma. Identification of prognostic groups and estimation of individual prognosis for 5093 patients. Cancer 1995; 75: 2484–2491.
Sober AJ, Day, CL, Fitzpatrick TB, et al. Early death from clinical stage I melanoma. J Invest Dermatol 1983; 80: 505–525.
Clark WH, From L, Bernardino EA, et al. The histogenesis and biologic behavior of primary human malignant melanomas of the skin. Cancer Res 1969; 29: 705–726.
Cohen MH, Ketcham AS, Felix EL, et al. Prognostic factors in patients undergoing lymphadectomy for malignant melanoma. Ann Surg 1977; 186: 635–642.
Breslow A, Macht S. Evaluation of prognosis in stage I cutaneous melanoma. Plast Reconstr Surg 1978; 61: 342–346.
Prade M, Sancho-Garnier H, Cesari JP, et al. Difficulties encountered in the application of the Clark’s classification and the Breslow thickness measurement in cutaneous malignant melanoma. Eur J Cancer 1980; 26: 159–163.
Lock-Anderson J, Hou-Jensen K, Hansen J, et al. Observer variation in histologic classification of cutaneous malignant melanoma. Scand J Plast Reconstr Surg Hand Surg 1995; 29: 141–148.
Breslow A. Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma. Ann Surg 1970; 172: 902–908.
Veronesi U, Cascinelli N, Morabito A, et al. Prognosis of stage I melanoma of the skin. Int J Cancer 1980; 26: 733–739.
Heenan PJ, Matz LR, Blackwell JB, et al. Inter-observer variation between pathologists in the classification of cutaneous malignant melanoma in Western Australia. Histopathology 1984; 8: 717–729.
Breslow A. Tumor thickness, level of invasion and node dissection in stage I cutaneous melanoma. Ann Surg 1975; 182: 572–575.
Day CL, Lew RA, Mihm MC Jr, et al. The natural break points for primary-tumor thickness in clinical stage I melanoma. N Engl J Med 1981; 305: 1155.
Mackie RM. Tumor thickness in melanoma. N Engl J Med 1982; 306: 1179–1180.
Kuehnl-Petzoldt C, Wiebelt H, Berger H. In what sense are breakpoints prognostic in malignant melanoma? Am J Dermatopathol 1984; 6 (1 Suppl): 349–350.
American Joint Committee on Cancer. Manual for Staging of Cancer, 3rd ed. JB Lippincott, Philadelphia, 1988.
Buttner P, Garbe C, Bertz J, et al. Primary cutaneous melanoma Primary cutoff points of tumor thickness and importance of Clark’s level for prognostic classification. Cancer 1995; 75: 2499–2506.
Kelly JW, Sagebiel RW, Clyman S, et al. Thin level IV malignant melanoma. Ann Surg 1985; 202: 98–103.
Shaw HM, McCarthy WH, McCarthy SW, et al. Thin malignant melanomas and recurrence potential. Arch Surg 1987; 122: 1147–1150.
Clark WH, Elder DE, Guerry D, et al. Model predicting survival in stage I melanoma based on tumor progression. J Natl Cancer Inst 1989; 81: 1893–1904.
Morton DL, Davtyan DG, Wanek LA, et al. Multivariate analysis of the relationship between survival and the microstage of primary melanoma by Clark level and Breslow thickness. Cancer 1993; 71: 3737–3743.
Buzaid AC, Ross MI, Balch CM, et al. Critical analysis of the current American Joint Committee on Cancer staging system for cutaneous melanoma and proposal of a new staging system. J Clin Oncol 1997; 15: 1039–1051.
Balch CM, Buzaid AC, Atkins MB, et al. A new American Joint Committee on Cancer staging system for cutaneous melanoma. Cancer 2000; 88: 1484–1491.
Graham CH, Rivers J, Kerbel RS, et al. Extent of vascularization as a prognostic indicator in thin (0.76 mm) malignant melanomas. Am J Pathol 1994; 145: 510–514.
Barnhill RL, Levy MA. Regressing thin cutaneous malignant melanomas (less than or equal to 1.00 mm) are associated with angiogenesis. Am J Pathol 1993; 143: 99–104.
Straume O, Akslen LA. Independent prognostic importance of vascular invasion in nodular melanomas. Cancer 1996; 78: 1211–1219.
Balch C. Cutaneous melanoma: prognosis and treatment results worldwide. Semin Surg Oncol 1992; 8: 400–414.
Schmoeckel C, Braun-Falco O. Prognostic index in malignant melanoma. Arch Dermatol 1978; 144: 871–873.
Halpern AC, Schuchter LM. Prognostic models in melanoma. Semin Oncol 1997; 24: S4–2-S4–7.
Vollmer RT. Malignant melanoma: a multivariate analysis of prognostic factors. Pathol Annu 1989; 24: 383–407.
Kelly JW, Sagebiel RW, Blois MS, et al. Regression in malignant melanoma: a histologic feature without independent prognostic significance. Cancer 1985; 56: 2287–2291.
Heenan PJ, English DR, D’Arcy C, et al. Survival among patients with clinical stage I cutaneous malignant melanoma diagnosed in western Australia in 1975/1976 and 1980/ 1981. Cancer 1991; 68: 2079–2087.
Coit DG. Prognostic factors in patients with melanoma metastatic to regional nodes. Surg Oncol ClinNAm 1992; 1: 281–295.
Buzaid AC, Tinoco LA, Jendiroba D, et al. Prognostic value of size of lymph node metastases in patients with cutaneous melanoma. J Clin Oncol 1995; 13: 2361–2368.
Bevilacqua R, Coit D, Rogatka A, et al. Axillary dissection in melanoma: prognostic variables in node-positive patients. Ann Surg 1990; 212: 125–131.
Drepper H, Bieb B, Hofherr B, et al. The prognosis of patients with stage III melanoma. Cancer 1993; 71: 1239–1246.
Shivers SC, Wang X, Li W, et al. Molecular staging of malignant melanoma. Correlation with clinical outcome. JAMA 1998; 280: 1410–1415.
Bostick PJ, Morton D1, Turner RR, et al. Prognostic significance of occult metastasis detected by sentinel lymphadenectomy and reverse transcriptase-polymerase chain reaction in early-stage melanoma patients. J Clin Oncol 1999; 17: 3238–3244.
Hayward N. New developments in melanoma genetics. Curr Oncol Rep 2000; 2: 300–306.
Greene MH. The genetics of hereditary melanoma and nevi. Cancer 1999; 86: 2464 2477.
Cowan JM, Halaban R, Francke U. Cytogenetic analysis of melanocytes from premalignant nevi and melanomas. J Natl Cancer Inst 1988; 80: 1159–1164.
Kamb A, Gruis NA, Weaver-Feldhaus J, et al. A cell cycle regulator potentially involved in genesis of many tumor types. Science 1994; 264: 436–440.
Hussussian CJ, Struewing JP, Goldstein AM, et al. Germline p16 mutations in familial melanoma. Nat Genet 1994; 8: 15–21.
Haluska FG, Hodi FS. Molecular genetics of familial cutaneous melanoma. J Clin Oncol 1998; 16: 670–682.
Barth A, Wanek L, Morton DL. Prognostic factors in 1,521 melanoma patients with distant metastasis. J Am Coll Surg 1995; 181: 193–201.
Eton O, Legha SS, Moon TE, et al. Prognostic factors for survival of patients treated systemically for disseminated melanoma. J Clin Oncol 1998; 16: 1103–1111.
Manola J, Atkins M, Ibrahim J, et al. Prognostic factors in metastatic melanoma: a pooled analysis of Eastern Cooperative Oncology Group trials. J Clin Oncol 2000; 18: 3782–3793.
Ryan L, Kramar A, Borden E. Prognostic factors in metastatic melanoma. Cancer 1993; 71: 2995–3005.
Curry BJ, Farrelly M, Hersey P. Evaluation of S-100(3 assays for the prediction of recurrence and prognosis in patients with AJCC stage I-III melanoma. Melanoma Res 1999; 9: 557–567.
von Schoultz E, Hansson LO, Djureen E, et al. Prognostic value of serum analysis of S-10013 protein in malignant melanoma. Melanoma Res 1993; 6: 133–137.
Bonfer JMG, Korse CM, Nieweg 0E, Rankin EM. The luminescence immunoassay S-100: a sensitive test to measure circulating S-10013: its prognostic value in malignant melanoma. Br J Cancer 1998; 77: 2210–2214.
Battayani Z, Grob JJ, Xerri L, et al. Polymerase chain reaction detection of circulating melanocytes as a prognostic marker in patients with melanoma. Arch Dermatol 1995; 131: 443–447.
Mellado B, Colomer D, Castel T, et al. Detection of circulating neoplastic cells by reverse-transcriptase polymerase chain reaction in malignant melanoma: association with clinical stage and prognosis. J Clin Oncol 1996; 14: 2091–2097.
Reinhold U, Ludtke-Handjery HC, Schnautz S, et al. The analysis of tyrosinase-specific mRNA in blood samples of melanoma patients by RT-PCR is not a useful test for metastatic tumor progression. J Invest Dermatol 1997; 108: 166–169.
Brossart P, Keilholz U, Willchauk M, et al. Hematogenous spread of malignant melanoma cells in different stages of disease. J Invest Dermatol 1993; 101: 887–889.
Brossart P, Schmier J, Kruger S, et al. A polymerase chain reaction-based semi-quantitative assessment of malignant melanoma cells in peripheral blood. Cancer Res 1995; 55: 4065–4068.
Hoon D, Wang Y, Dale P, et al. Detection of occult melanoma cells in blood with a multiple-marker polymerase chain reaction assay. J Clin Oncol 1995; 13: 2109–2116.
Battayani Z, Xerri L, Hassoun J, et al. Tyrosine gene expression in human tissues. Pigment Cell Res 1993; 6: 400–405.
Foss A, Guille M, Occleston N, et al. The detection of melanoma cells in peripheral blood by reverse transcription-polymerase chain reaction. Br J Cancer 1995; 72: 155–159.
Kunter U, Buer J, Probst M, et al. Peripheral blood tyrosinase messenger RNA detection and survival in malignant melanoma. J Natl Cancer Inst 1996; 88: 590–594.
Pittman K, Burchill S, Smith B, et al. Reverse transcriptase-polymerase chain reaction for expression of tyrosinase to identify malignant melanoma cells in peripheral blood. Ann Oncol 1996; 7: 297–301.
Jung FA, Buzaid AC, Ross MI, et al. Evaluation of tyrosinase as a tumor marker in the blood of melanoma patients. J Clin Oncol 1997; 15: 2826–2831.
Smith B, Shelby P, Southgate J, et al. Detection of melanoma cells in peripheral blood by means of reverse transcriptase and polymerase chain reaction. Lancet 1991; 338: 1227 1229.
Palmieri G, Strazzullo M, Ascierto PA, et al. Polymerase chain reaction-based detection of circulation melanoma cells as an effective marker of tumor progression. J Clin Oncol 1999; 17: 304–311.
Hoon, DS, Bostick P, Kuo C, et al. Molecular markers in blood as surrogate prognostic indicators of melanoma recurrence. Cancer Res 2000; 60: 2253–2257.
Keilholz U. Diagnostic PCR in melanoma, methods and quality assurance. Eur J Cancer 1996; 32: 1661–1663.
Keilholz U. Reliability of reverse transcription-polymerase chain reaction (RT-PCR)-based assays for the detection of circulating tumor cells: a quality-assurance initiative of the EORTC Melanoma Cooperative Group. Eur J Cancer 1998; 34: 750–753.
Deichmann M, Benner A, Bock M, et al. S 100-beta, melanoma-inhibiting activity, and lactate dehydrogenase discriminate progressive from nonprogressive American Joint Committee on Cancer stage IV melanoma. J Clin Oncol 1999; 17: 1891–1896.
Mackie RM, Carfrae DC, Cochran AJ. Assessment of prognosis in patients with malignant melanoma. Lancet 1972; 2: 455–4546.
Cochran AJ, Elashoff D, Morton DL, et al. Individualized prognosis for melanoma patients. Hum Pathol 2000; 31: 327–331.
Gershenwald JE. Pittsburgh Perspective in Melanoma Meeting, Pittsburgh, PA, June 1–2, 2000.
Melanoma Consensus Conference, Atlanta Georgia, April 1–2, 2000.
Balch CM, Bozaid AC, Soong SJ, et al. Final version of the American Joint Committee on Cancer Staging system for cutaneous melanoma. J Clin Oncol 19: 3635–3648, 2001.
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Daw, H., Olencki, T. (2002). Clinical Prognostic Factors and Staging. In: Borden, E.C. (eds) Melanoma. Current Clinical Oncology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-159-6_3
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DOI: https://doi.org/10.1007/978-1-59259-159-6_3
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