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The Importance of Anatomic Site in Prognosis in Patients With Cutaneous Melanoma

The Importance of Anatomic Site in Prognosis in Patients With Cutaneous Melanoma Abstract • To determine the prognostic relevance of the anatomic site of origin of cutaneous melanoma to survival, we retrospectively analyzed a computerized database of 3428 patients with stage I and II cutaneous melanoma. Patients were stratified by the recognized prognostic variables of stage of disease, Clark's level of invasion of the primary lesion, and the nodal involvement at the time of lymphadenectomy. Melanoma arising in skin of the upper part of the back, back of the arms, neck, and scalp (BANS) region occurred more frequently in male than female patients. There were no statistically significant differences in the distribution of Clark's level of invasion of BANS and non-BANS region primary melanomas or in the extent of nodal involvement in patients with stage II disease. The 5-year actuarial survival of patients with stage I BANS region melanomas was 87%; stage I non-BANS, 89%; stage II BANS, 38%; and stage II non-BANS, 69%. The BANS region appears to have prognostic significance in cutaneous melanoma and, particularly, in patients with stage II melanoma. (Arch Surg. 1991;126:486-489) References 1. Balch CM, Soon SJ, Shaw HM. A comparison of worldwide melanoma data . In: Balch CM, Milton GW, eds. Cutaneous Melanoma . Philadelphia, Pa: JB Lippincott Co; 1985:507-518. 2. Clark WH, From L, Bernardinoa EA, Mihm MC. The histogenesis and biologic behavior of primary human malignant melanoma of the skin . Cancer Res . 1969;29:705-727. 3. Breslow A. Tumor thickness, level of invasion and node dissection in stage I cutaneous melanoma . Ann Surg . 1975;182:572-575.Crossref 4. Breslow A. Thickness of cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma . Ann Surg . 1970;172:902-908.Crossref 5. Balch CM, Murad TM, Soong SJ, Ingalls AL, Halpern NB, Maddox WA. A multifactorial analysis of melanoma: prognostic histopathological features comparing Clark's and Breslow's staging methods . Ann Surg . 1977;188: 732-742.Crossref 6. Balch CM, Soong SJ, Milton GW, et al. A comparison of prognostic factors and surgical results in 1,786 patients with localized (stage I) melanoma treated in Alabama, USA, and New South Wales, Australia . Ann Surg . 1982;196: 677-684.Crossref 7. Present CA. Malignant melanoma of mucosal sites . In: Constanzi JJ, ed. Malignant Melanoma . Boston, Mass: Martinus Nijhoff; 1983:55-83. 8. Wanebo HJ, Woodruff JM, Farr GH, Quan SH. Anorecto melanoma . Cancer . 1981;47:1891-1900.Crossref 9. Shah JP, Huvos AG, Strong EW. Mucosal melanoma of the head and neck . Am J Surg . 1977;134:531-535.Crossref 10. Day CL, Mihm MC, Lew RA, et al. Prognostic factors for patients with clinical stage I melanoma of intermediate thickness (1.51-3.99 mm): a conceptual model for tumor growth and metastasis . Ann Surg . 1982;195:35-43.Crossref 11. Rogers GS, Kopf AW, Rigel DS, et al. Effect of anatomical location on prognosis in patients with clinical stage I melanoma . Arch Dermatol . 1982;119:644-649.Crossref 12. Urist MM, Balch CM, Soong SJ, et al. Head and neck melanoma in 534 clinical stage I patients . Ann Surg . 1984;200:769-775.Crossref 13. Ames FC, Sugarbaker EV, Ballantyne AJ. Analysis of survival and disease control in stage I melanoma of the head and neck . Am J Surg . 1976;132:484-491.Crossref 14. Day CL, Mihm MC, Sober AJ, et al. Prognostic factors for melanoma patients with lesions 0.76-1.69 mm in thickness: an appraisal of'thin' level IV lesions . Ann Surg . 1982;195:30-34.Crossref 15. Cascinelli N, Vaglini M, Bufalin R, Morabito A. BANS: a cutaneous region with no prognostic significance in patients with melanoma . Cancer . 1986;57:441-444.Crossref 16. Morton DL. Surgical treatment for malignant melanoma . Clin Oncol . 1984;3:517-529. 17. Morton DL, Foshag LJ, Nizze JA, et al. Active specific immunotherapy in malignant melanoma . Semin Surg Oncol . 1989;5:420-425.Crossref 18. Kaplan EL, Meier P. Non parametric estimations from incomplete observations . J Am Stat Assoc . 1958;53:457-481.Crossref 19. Morton DL, Roe DJ, Cochran AJ. Melanoma in the Western United States: experience with stage II melanoma at the UCLA Medical Center . In: Balch CM, Milton GW, eds. Cutaneous Melanoma . Philadelphia, Pa: JB Lippincott Co; 1985:419-430. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

The Importance of Anatomic Site in Prognosis in Patients With Cutaneous Melanoma

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References (19)

Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1991.01410280090013
Publisher site
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Abstract

Abstract • To determine the prognostic relevance of the anatomic site of origin of cutaneous melanoma to survival, we retrospectively analyzed a computerized database of 3428 patients with stage I and II cutaneous melanoma. Patients were stratified by the recognized prognostic variables of stage of disease, Clark's level of invasion of the primary lesion, and the nodal involvement at the time of lymphadenectomy. Melanoma arising in skin of the upper part of the back, back of the arms, neck, and scalp (BANS) region occurred more frequently in male than female patients. There were no statistically significant differences in the distribution of Clark's level of invasion of BANS and non-BANS region primary melanomas or in the extent of nodal involvement in patients with stage II disease. The 5-year actuarial survival of patients with stage I BANS region melanomas was 87%; stage I non-BANS, 89%; stage II BANS, 38%; and stage II non-BANS, 69%. The BANS region appears to have prognostic significance in cutaneous melanoma and, particularly, in patients with stage II melanoma. (Arch Surg. 1991;126:486-489) References 1. Balch CM, Soon SJ, Shaw HM. A comparison of worldwide melanoma data . In: Balch CM, Milton GW, eds. Cutaneous Melanoma . Philadelphia, Pa: JB Lippincott Co; 1985:507-518. 2. Clark WH, From L, Bernardinoa EA, Mihm MC. The histogenesis and biologic behavior of primary human malignant melanoma of the skin . Cancer Res . 1969;29:705-727. 3. Breslow A. Tumor thickness, level of invasion and node dissection in stage I cutaneous melanoma . Ann Surg . 1975;182:572-575.Crossref 4. Breslow A. Thickness of cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma . Ann Surg . 1970;172:902-908.Crossref 5. Balch CM, Murad TM, Soong SJ, Ingalls AL, Halpern NB, Maddox WA. A multifactorial analysis of melanoma: prognostic histopathological features comparing Clark's and Breslow's staging methods . Ann Surg . 1977;188: 732-742.Crossref 6. Balch CM, Soong SJ, Milton GW, et al. A comparison of prognostic factors and surgical results in 1,786 patients with localized (stage I) melanoma treated in Alabama, USA, and New South Wales, Australia . Ann Surg . 1982;196: 677-684.Crossref 7. Present CA. Malignant melanoma of mucosal sites . In: Constanzi JJ, ed. Malignant Melanoma . Boston, Mass: Martinus Nijhoff; 1983:55-83. 8. Wanebo HJ, Woodruff JM, Farr GH, Quan SH. Anorecto melanoma . Cancer . 1981;47:1891-1900.Crossref 9. Shah JP, Huvos AG, Strong EW. Mucosal melanoma of the head and neck . Am J Surg . 1977;134:531-535.Crossref 10. Day CL, Mihm MC, Lew RA, et al. Prognostic factors for patients with clinical stage I melanoma of intermediate thickness (1.51-3.99 mm): a conceptual model for tumor growth and metastasis . Ann Surg . 1982;195:35-43.Crossref 11. Rogers GS, Kopf AW, Rigel DS, et al. Effect of anatomical location on prognosis in patients with clinical stage I melanoma . Arch Dermatol . 1982;119:644-649.Crossref 12. Urist MM, Balch CM, Soong SJ, et al. Head and neck melanoma in 534 clinical stage I patients . Ann Surg . 1984;200:769-775.Crossref 13. Ames FC, Sugarbaker EV, Ballantyne AJ. Analysis of survival and disease control in stage I melanoma of the head and neck . Am J Surg . 1976;132:484-491.Crossref 14. Day CL, Mihm MC, Sober AJ, et al. Prognostic factors for melanoma patients with lesions 0.76-1.69 mm in thickness: an appraisal of'thin' level IV lesions . Ann Surg . 1982;195:30-34.Crossref 15. Cascinelli N, Vaglini M, Bufalin R, Morabito A. BANS: a cutaneous region with no prognostic significance in patients with melanoma . Cancer . 1986;57:441-444.Crossref 16. Morton DL. Surgical treatment for malignant melanoma . Clin Oncol . 1984;3:517-529. 17. Morton DL, Foshag LJ, Nizze JA, et al. Active specific immunotherapy in malignant melanoma . Semin Surg Oncol . 1989;5:420-425.Crossref 18. Kaplan EL, Meier P. Non parametric estimations from incomplete observations . J Am Stat Assoc . 1958;53:457-481.Crossref 19. Morton DL, Roe DJ, Cochran AJ. Melanoma in the Western United States: experience with stage II melanoma at the UCLA Medical Center . In: Balch CM, Milton GW, eds. Cutaneous Melanoma . Philadelphia, Pa: JB Lippincott Co; 1985:419-430.

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Archives of Surgery – American Medical Association

Published: Apr 1, 1991

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