Association of classical prognostic factors and the death risk in invasive cutaneous melanoma

Keywords

melanoma - prognostic factors - epidemiology

Introduction: Invasive cutaneous melanoma is a malignant neoplasm with heterogeneous characteristics, exhibiting different clinical and biological behaviors.

Objective: To analyze the association of classical histopathological risk factors (Clark, Breslow, ulceration, lymphocytic infiltration, and number of mitoses/mm²) with the occurrence of death in patients with invasive melanoma.

Method: This is an excerpt from a retrospective cohort study consisting of 221 participants treated at the oncology service (COC Erechim, RS) from 2000 to 2023. Data were obtained from medical records. Inclusion in the cohort was based on the date of the confirmatory histopathological examination of melanoma, with censures being the date of death or the last recorded follow-up date in the medical records. The median follow-up of the cohort was over 13 years. To analyze the association between prognostic variables and the outcome of death, specific hazard ratios were calculated, and statistical significances were determined using the Cox Proportional Hazards method. The research was approved by the Ethics Committee of the Regional Integrated University (URI - Erechim Campus) under CAAE 6.136.573.

Results: The median age of the cohort participants was 54 years, with 51.1% women and 48.9% men. There were 27 deaths during the follow-up period. The prognostic variables of interest were analyzed concerning their association with the occurrence of death. The analysis of the lymphocytic infiltration variable did not show statistical significance in the studied relationship. The variables: Clark IV (HR 44.96 (6.01-336.26) p<0.001); Clark V (HR 54.60 (6.71-443.86) p<0.001), Breslow index of 2.26-3.0mm (HR 48.28 (5.80-401.80) p<0.001); Breslow index >3.0mm (HR 62.24 (8.21-472.05) p<0.001), and the number of mitoses above 5/mm² (HR 14.03 (2.34-84.25)) were identified as independent markers of poor prognosis.

Conclusions: The Clark classification, Breslow index, analysis of ulceration in the primary lesion, and the number of mitoses by histological analysis are important predictive risk factors related to death in individuals with invasive cutaneous melanoma.

Corresponding author: Louise Zanardo Sartori (e-mail: [e-mail]).

 

MissingLinkText

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
06 May 2025