Prognostic sub-classifications of T1 cutaneous melanomas based on ulceration, tumour thickness and Clark's level of invasion. Results of a population-based study from the Swedish Melanoma Register.

Research output: Contribution to journalArticle

Abstract

Background: Survival and prognostic factors for thin melanomas have been relatively little studied in population-based settings. This patient group account for the majority of melanomas diagnosed in western countries today and better prognostic information is needed. Objective: The aim of this study is to use established prognostic factors such as ulceration, tumour thickness and Clark's level of invasion for risk stratification of T1 cutaneous melanoma. Methods: During 1990-2008, the Swedish Melanoma Register (SMR) included 97% of all melanomas diagnosed in Sweden. All together 13 026 patients with T1 melanomas in clinical stage I were used for estimating melanoma-specific 10- and 15-year mortality rates. Cox regression model was used for further survival analysis on 11 165 patients with complete data. Results: Ulceration, tumour thickness and Clark's level of invasion all showed significant independent long-term prognostic information. By combining these factors the patients could be subdivided into three risk groups: a low risk group (67·9% of T1 cases) with a 10-year melanoma-specific mortality rate of 1·5% (1·2-1·9%), an intermediate risk group (28·6% of T1 cases) with a 10-year mortality rate of 6·1% (5·0-7·3%) and a high risk group (3·5% of T1 cases) with a 10-year mortality rate of 15·6% (11·2-21·4%). The high- and intermediate risk group accounted for 66% of melanoma deaths within T1. Conclusions: Using a population-based melanoma register and combining ulceration, tumour thickness and Clark's level of invasion three distinct prognostic subgroups were identified.

Details

Authors
  • J Lyth
  • J Hansson
  • Christian Ingvar
  • E Månsson-Brahme
  • P Naredi
  • U Stierner
  • G Wagenius
  • C Lindholm
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Dermatology and Venereal Diseases
Original languageEnglish
Pages (from-to)779-786
JournalBritish Journal of Dermatology
Volume168
Issue number4
Publication statusPublished - 2013
Publication categoryResearch
Peer-reviewedYes