Prognostic stratification of ulcerated melanoma

not only the extent matters

Marie L Bønnelykke-Behrndtz, Henrik Schmidt, Ib Jarle Christensen, Tine E Damsgaard, Holger J Møller, Lars Bastholt, Peter H Nørgaard, Torben Steiniche

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVES: For patients with melanoma, ulceration is an important prognostic marker and interestingly also a predictive marker for the response of adjuvant interferon. A consensual definition and accurate assessment of ulceration are therefore crucial for proper staging and clinical management. We evaluated the prognostic impact of the extent and type of ulceration and the epidermal involvement theoretically preceding it (consumption of epidermis and cleft formation) or seen subsequent to the inflammation (reepithelialization and reactive epidermal hyperplasia), aiming for better prognostic stratification of ulcerated lesions.

METHODS: From H&E-stained sections, the status (presence vs absence), extent (percentage of the total tumor length), and type (infiltrative vs attenuative) of ulceration and epidermal involvement were evaluated from 385 patients with cutaneous melanoma.

RESULTS: The presence of ulceration (hazard ratio [HR], 1.83), an attenuative type of ulceration (HR, 3.02), and excessive ulceration (HR, 3.57) were independent predictors of poor melanoma-specific survival. Further subdivision of minimal/moderate ulceration showed independent prognostic value only for lesions with epidermal involvement of the surrounding epidermis (HR, 1.78).

CONCLUSION: The extent and type of ulceration and involvement of the surrounding epidermis provided more accurate prognostic information than the mere absence or presence and may be useful markers allowing better stratification of ulcerated lesions.

OriginalsprogEngelsk
TidsskriftAmerican Journal of Clinical Pathology
Vol/bind142
Udgave nummer6
Sider (fra-til)845-856
ISSN0002-9173
DOI
StatusUdgivet - 2014

Fingeraftryk

Epidermis
Melanoma
Hyperplasia
Skin
Neoplasms

Citer dette

Bønnelykke-Behrndtz, M. L., Schmidt, H., Christensen, I. J., Damsgaard, T. E., Møller, H. J., Bastholt, L., ... Steiniche, T. (2014). Prognostic stratification of ulcerated melanoma: not only the extent matters. American Journal of Clinical Pathology, 142(6), 845-856. https://doi.org/10.1309/AJCPW56PHGLFTKZC
Bønnelykke-Behrndtz, Marie L ; Schmidt, Henrik ; Christensen, Ib Jarle ; Damsgaard, Tine E ; Møller, Holger J ; Bastholt, Lars ; Nørgaard, Peter H ; Steiniche, Torben. / Prognostic stratification of ulcerated melanoma : not only the extent matters. I: American Journal of Clinical Pathology. 2014 ; Bind 142, Nr. 6. s. 845-856.
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title = "Prognostic stratification of ulcerated melanoma: not only the extent matters",
abstract = "OBJECTIVES: For patients with melanoma, ulceration is an important prognostic marker and interestingly also a predictive marker for the response of adjuvant interferon. A consensual definition and accurate assessment of ulceration are therefore crucial for proper staging and clinical management. We evaluated the prognostic impact of the extent and type of ulceration and the epidermal involvement theoretically preceding it (consumption of epidermis and cleft formation) or seen subsequent to the inflammation (reepithelialization and reactive epidermal hyperplasia), aiming for better prognostic stratification of ulcerated lesions.METHODS: From H&E-stained sections, the status (presence vs absence), extent (percentage of the total tumor length), and type (infiltrative vs attenuative) of ulceration and epidermal involvement were evaluated from 385 patients with cutaneous melanoma.RESULTS: The presence of ulceration (hazard ratio [HR], 1.83), an attenuative type of ulceration (HR, 3.02), and excessive ulceration (HR, 3.57) were independent predictors of poor melanoma-specific survival. Further subdivision of minimal/moderate ulceration showed independent prognostic value only for lesions with epidermal involvement of the surrounding epidermis (HR, 1.78).CONCLUSION: The extent and type of ulceration and involvement of the surrounding epidermis provided more accurate prognostic information than the mere absence or presence and may be useful markers allowing better stratification of ulcerated lesions.",
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Bønnelykke-Behrndtz, ML, Schmidt, H, Christensen, IJ, Damsgaard, TE, Møller, HJ, Bastholt, L, Nørgaard, PH & Steiniche, T 2014, 'Prognostic stratification of ulcerated melanoma: not only the extent matters', American Journal of Clinical Pathology, bind 142, nr. 6, s. 845-856. https://doi.org/10.1309/AJCPW56PHGLFTKZC

Prognostic stratification of ulcerated melanoma : not only the extent matters. / Bønnelykke-Behrndtz, Marie L; Schmidt, Henrik; Christensen, Ib Jarle; Damsgaard, Tine E; Møller, Holger J; Bastholt, Lars; Nørgaard, Peter H; Steiniche, Torben.

I: American Journal of Clinical Pathology, Bind 142, Nr. 6, 2014, s. 845-856.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Prognostic stratification of ulcerated melanoma

T2 - not only the extent matters

AU - Bønnelykke-Behrndtz, Marie L

AU - Schmidt, Henrik

AU - Christensen, Ib Jarle

AU - Damsgaard, Tine E

AU - Møller, Holger J

AU - Bastholt, Lars

AU - Nørgaard, Peter H

AU - Steiniche, Torben

N1 - Copyright© by the American Society for Clinical Pathology.

PY - 2014

Y1 - 2014

N2 - OBJECTIVES: For patients with melanoma, ulceration is an important prognostic marker and interestingly also a predictive marker for the response of adjuvant interferon. A consensual definition and accurate assessment of ulceration are therefore crucial for proper staging and clinical management. We evaluated the prognostic impact of the extent and type of ulceration and the epidermal involvement theoretically preceding it (consumption of epidermis and cleft formation) or seen subsequent to the inflammation (reepithelialization and reactive epidermal hyperplasia), aiming for better prognostic stratification of ulcerated lesions.METHODS: From H&E-stained sections, the status (presence vs absence), extent (percentage of the total tumor length), and type (infiltrative vs attenuative) of ulceration and epidermal involvement were evaluated from 385 patients with cutaneous melanoma.RESULTS: The presence of ulceration (hazard ratio [HR], 1.83), an attenuative type of ulceration (HR, 3.02), and excessive ulceration (HR, 3.57) were independent predictors of poor melanoma-specific survival. Further subdivision of minimal/moderate ulceration showed independent prognostic value only for lesions with epidermal involvement of the surrounding epidermis (HR, 1.78).CONCLUSION: The extent and type of ulceration and involvement of the surrounding epidermis provided more accurate prognostic information than the mere absence or presence and may be useful markers allowing better stratification of ulcerated lesions.

AB - OBJECTIVES: For patients with melanoma, ulceration is an important prognostic marker and interestingly also a predictive marker for the response of adjuvant interferon. A consensual definition and accurate assessment of ulceration are therefore crucial for proper staging and clinical management. We evaluated the prognostic impact of the extent and type of ulceration and the epidermal involvement theoretically preceding it (consumption of epidermis and cleft formation) or seen subsequent to the inflammation (reepithelialization and reactive epidermal hyperplasia), aiming for better prognostic stratification of ulcerated lesions.METHODS: From H&E-stained sections, the status (presence vs absence), extent (percentage of the total tumor length), and type (infiltrative vs attenuative) of ulceration and epidermal involvement were evaluated from 385 patients with cutaneous melanoma.RESULTS: The presence of ulceration (hazard ratio [HR], 1.83), an attenuative type of ulceration (HR, 3.02), and excessive ulceration (HR, 3.57) were independent predictors of poor melanoma-specific survival. Further subdivision of minimal/moderate ulceration showed independent prognostic value only for lesions with epidermal involvement of the surrounding epidermis (HR, 1.78).CONCLUSION: The extent and type of ulceration and involvement of the surrounding epidermis provided more accurate prognostic information than the mere absence or presence and may be useful markers allowing better stratification of ulcerated lesions.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Kaplan-Meier Estimate

KW - Male

KW - Melanoma

KW - Middle Aged

KW - Prognosis

KW - Proportional Hazards Models

KW - Retrospective Studies

KW - Skin Neoplasms

KW - Ulcer

KW - Young Adult

U2 - 10.1309/AJCPW56PHGLFTKZC

DO - 10.1309/AJCPW56PHGLFTKZC

M3 - Journal article

VL - 142

SP - 845

EP - 856

JO - American Journal of Clinical Pathology

JF - American Journal of Clinical Pathology

SN - 0002-9173

IS - 6

ER -