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Outcomes and prognostic factors in nodular melanomas.
- Source :
-
Surgery [Surgery] 2012 Oct; Vol. 152 (4), pp. 652-9; discussion 659-60. Date of Electronic Publication: 2012 Aug 25. - Publication Year :
- 2012
-
Abstract
- Background: The nodular subtype of cutaneous melanoma has a more pronounced vertical phase and less of a radial growth phase compared with other histologic subtypes. This study was performed to determine prognostic factors and outcomes for nodular melanomas.<br />Methods: A post hoc analysis of a prospective clinical trial was performed in all patients with nodular histologic subtype. Univariate and multivariate analyses of factors associated with disease-free survival (DFS), overall survival (OS), and local and in-transit recurrence-free survival (LITRFS) were performed. Kaplan-Meier survival analyses were performed.<br />Results: There were 736 patients available for analysis, and 189 (25.7%) were sentinel lymph node (SLN) positive. Breslow thickness of ≥2.3 mm, presence of ulceration, nonextremity tumor location, positive SLN, and non-SLN-positive status were independent risk factors for worse OS and DFS. Kaplan-Meier analysis demonstrated that ulceration predicted worse OS and DFS in all nodular melanoma patients, and in both SLN-positive and -negative subsets. The presence of ulceration and a positive SLN together predicted significantly worse DFS and OS.<br />Conclusion: The most important risk factors that determine prognosis in nodular melanomas are SLN status and ulceration. The presence of both a positive SLN and ulceration significantly affect DFS and OS, and to a lesser degree LITRFS.<br /> (Copyright © 2012 Mosby, Inc. All rights reserved.)
- Subjects :
- Disease-Free Survival
Female
Humans
Kaplan-Meier Estimate
Lymphatic Metastasis
Male
Melanoma secondary
Middle Aged
Multivariate Analysis
Prognosis
Prospective Studies
Risk Factors
Sentinel Lymph Node Biopsy
Skin Ulcer pathology
Treatment Outcome
Melanoma pathology
Melanoma surgery
Skin Neoplasms pathology
Skin Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1532-7361
- Volume :
- 152
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 22925134
- Full Text :
- https://doi.org/10.1016/j.surg.2012.07.006