Effect of anatomical location on prognosis in patients with clinical stage I melanoma.

A study of the influence of the anatomical location of malignant melanoma on the prognosis of 971 patients with stage I disease disclosed specific high-, intermediate-, and low-risk sites. High-risk sites included scalp, mandibular area, midline of trunk (anterior and posterior), upper medial thighs, hands, feet (except the arches), popliteal fossae, and genitalia. The life-table-adjusted five-year disease-free survival was 54% in the high-risk locations, 79% in intermediate-risk locations, and 93% in low-risk sites.

Regression in malignant melanoma.

A multiple stepwise logistic regression analysis shows that histologic regression is more likely to be found in a malignant melanoma that is level III or less, more than 10 mm in diameter, associated with solar elastosis, located on an anatomic area other than the head or neck, and when there are areas of whiteness clinically. Although patients with malignant melanomas displaying signs of regression histologically have a slightly better 5-year disease-free survival, this may be attributed to a difference in tumor thickness.

"Small" melanomas: relation of prognostic variables to diameter of primary superficial spreading melanomas.

In a consecutive series of 648 superficial spreading melanomas a significantly better 5-year disease-free survival rate was observed for patients whose primary tumors were 14 mm or less in diameter when compared with those 15 mm or larger in diameter. Other distinguishing features of the group of "smaller" superficial spreading melanomas were that they occurred in younger patients; were of shorter durations; were more common in women; occurred disproportionately on the lower limbs; were less elevated; tended to be round in shape; were thinner (Breslow); penetrated less deeply (Clark levels); showed less histologic regression; and developed fewer metastases. Based on these findings it is recommended that educational programs be undertaken for the medical profession and for the public to promote early diagnosis and prompt treatment of superficial spreading melanomas when they are small in diameter and more often curable.

A multivariate analysis of prognostic factors for melanoma patients with lesions greater than or equal to 3.65 mm in thickness. The importance of revealing alternative Cox models.

Fourteen prognostic factors were examined in 79 patients with clinical Stage I melanoma greater than or equal to 3.65 mm in thickness. All nine patients with melanoma of the hands or feet died of melanoma.

Prognostic factors for patients with clinical stage I melanoma of intermediate thickness (1.51 - 3.39 mm). A conceptual model for tumor growth and metastasis.

Fourteen variables were tested for their ability to predict visceral or bony metastases in 177 patients with clinical Stage I melanoma of intermediate thickness (1.51 - 3.39 mm).

Prognostic factors for melanoma patients with lesions 0.76 - 1.69 mm in thickness. An appraisal of "thin" level IV lesions.

Fourteen variables were tested for their prognostic usefulness in 203 patients with clinical Stage I melanoma and primary tumor 0.76-169 mm thick. Only two variables, primary tumor location and level of invasion, were useful in predicting death from melanoma for these patients.

Factors related to thickness of melanoma. Multifactorial analysis off variables correlated with thickness of superficial spreading malignant melanoma in man.

Computer analyses to identify correlations between thickness of primary superficial spreading malignant melanoma and eighteen variables previously reported to be related to prognosis were performed on a series of malignant melanomas. The variables that showed statistically significant (less than or equal to 0.05) direct relationships to thickness were level (Clark), elevation of lesion, age of patient, least and greatest diameters of lesion, history of bleeding, ulceration, clinical and histologic stage, anatomic location, pedunculation, and satellitosis.

Correlation of thicknesses of superficial spreading malignant melanomas and ages of patients.

In a prospective study of 455 consecutive patients with superficial spreading malignant melanomas entered into the data base of the Melanoma Cooperative Group of New York University Medical Center, it was found by linear-regression analysis that there is a statistically significant (p = 0.005) positive correlation between the ages of the patients and the thickness of their lesions. Although the reasons for the correlation between ages and thicknesses ae not certain, several possible explanations were considered, namely: (1) the greater prevalence of superficial spreading malignant melanomas in the aged on the lower limbs where thicker lesions were present in our patients, (2) the altered skin of the elderly, which may favor deeper penetration by these neoplasms, (3) impaired immunologic responses in the aged, (4) the delay in diagnosis of malignant melanomas in the elderly because of obsuration of them by numerous benign pigmented lesions that frequently develop with aging, and (5) lesser concern of the elderly with their physical appearances in particular and medical problems in general.

A prognostic model for clinical stage I melanoma of the upper extremity. The importance of anatomic subsites in predicting recurrent disease.

Thirteen variables were studied for their relative usefulness in predicting recurrent disease in 107 patients with clinical Stage I melanoma of the upper extremity. After a mean follow-up period of 54 months, the only patents who have had recurrent disease to date are those who primary lesions were located either on the hand or posterior upper arm. The five-year disease-free survival role for 44 patients with melanoma at these sites was 68%.

The significance of augmented radiocolloid uptake by the spleen in patients with malignant melanoma.

Increase in splenic uptake of Tc-99m sulfur colloid was noted in 47 of 147 (32%) patients with cutaneous malignant melanoma early in the coure of disease. Patients with disseminated disease and/or clinical or laboratory evidence of hapatic dysfunction were excluded from study. Recurrence rate of 2 yr was higher for those patients with splenic scans demonstrating augmented uptake compared with patients having normal scans, 36% against 16% (p less than 0.

Malignant melanoma in spouses.

A study of three married couples where both spouses developed malignant melanoma was undertaken at the New York University-Bellevue Medical Center melanoma registry. An upper bound was calculated for the number of spouses expected to develop melanoma, along with the origin of the disease and its relation to nation-wide rates of incidence. The observed number was six times greater than the bound.

Ultrastructural study of superficial spreading melanoma and benign simulants.

Ultrastructural examination of the intraepidermal component of superficial spreading melanomas (SSM) and benign melanocytic lesions was undertaken to determine the diagnostic value of electron microscopy in clinically "borderline" melanoma problems. Seventeen SSMs and ten benign melanocytic nevi and lentigenes which clinically resembled melanoma were studied. Melanocytes of the intraepidermal component of the SSMs showed a greater tendency for abnormal melanosome formation than did melanocytes of the benign simulants.

Distribution of technetium-99m sulfur colloid in mice bearing melanomas or mammary carcinomas.

Three groups of 24 C57BL/6J black mice were studied. One group was implanted with B16 malignant melanoma, another was implanted with mammary adenocarcinoma, and the third was not given tumor implants. After 14 to 17 days, the mice were given injections i.

Familial malignant melanoma.

Two sisters simultaneously developed a superficial spreading malignant melanoma on their legs. Concurrently, a brother was affected with fatal metastatic melanoma. Several explanations for familial malignant melanoma are reviewed, including: 1.

Diagnostic accuracy in malignant melanoma.

The diagnostic accuracy and index of suspicion concerning malignant melanoma were calculated based on review of 5,538 histologically examined lesions (of which 99 were melanomas) that were recorded in the Oncology Section of the Skin and Cancer Unit from 1955 to 1967. The diagnostic accuracy of the physicians in the Section was determined to be 64.4%.