Cutaneous melanoma: estimating survival and recurrence risk based on histopathologic features

Authors

  • David E. Elder,

    1. Melanoma Program of the Abramson Cancer Center, Department of Pathology and Laboratory Medicine, the Center for Biostatistics and Epidemiology, and the Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    Search for more papers by this author
  • Phyllis A. Gimotty,

    1. Melanoma Program of the Abramson Cancer Center, Department of Pathology and Laboratory Medicine, the Center for Biostatistics and Epidemiology, and the Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    Search for more papers by this author
  • DuPont Guerry

    1. Melanoma Program of the Abramson Cancer Center, Department of Pathology and Laboratory Medicine, the Center for Biostatistics and Epidemiology, and the Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    Search for more papers by this author

Address correspondence and reprint requests to: David E. Elder, MB, ChB, FRCPA, Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, or email: elder@mail.med.upenn.edu.

Abstract

ABSTRACT:  The prognosis of melanoma is best understood in terms of a model of tumor progression, in which most melanomas may evolve through two major phases of progression: from a lesion that is nontumorigenic and has little or no capacity for metastasis; to a more advanced lesion that is tumorigenic and may have capacity for metastasis. The likelihood of metastasis varies with a number of attributes of the primary melanoma, including the phase of progression, the Breslow tumor thickness, mitotic rate, and host response to the tumorigenic compartment of the lesion, Clark's level of invasion, and other factors. When distant metastasis has occurred, the prognosis for the patient is very poor. In this monograph, the focus will be the discussion of factors related to the prognosis of melanomas that at diagnosis are clinically localized to the primary site.

Ancillary