ArticleJournal of the National Cancer Institute2019
Distinct Clinicopathological and Prognostic Features of Thin Nodular Primary Melanomas: An International Study from 17 Centers.
Article in Journal of the National Cancer Institute, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 47 citations in OpenAlex.
- Anatomical site and histological subtype as determinants of Breslow thickness and high-risk features in surgically managed cutaneous melanoma at Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.Frontiers in surgery · 2026Article
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- Sentinel lymph node biopsy status improves adjuvant therapy decision-making in patients with clinical stage IIB/C melanoma: A population-based analysis.Journal of the American Academy of Dermatology · 2023Article
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- Metastatic multifocal melanoma of multiple organ systems: A case report.World journal of clinical cases · 2022Article
- Acral lentiginous melanoma histotype predicts outcome in clinical stage I-II melanoma patients: an International multicenter study.ESMO open · 2022Article
- Loss of 'Epidermal Melanin Unit' Integrity in Human Skin During Melanoma-Genesis.Frontiers in oncology · 2022Review
- Clinical Clues to Avoid Missing Melanoma When Morphology is Not Enough.Dermatology practical & conceptual · 2021Article
- Multivariate analysis of prognostic factors in patients with nodular melanoma.Journal of cancer research and clinical oncology · 2021Article
- Comparison of community pathologists with expert dermatopathologists evaluating Breslow thickness and histopathologic subtype in a large international population-based study of melanoma.JAAD international · 2021Article
- Patient-identified early clinical warning signs of nodular melanoma: a qualitative study.BMC cancer · 2021Article
- Subtyping Cutaneous Melanoma Matters.JNCI cancer spectrum · 2020Article
- Dermatoscopic features of thin (≤2 mm Breslow thickness) vs. thick (>2 mm Breslow thickness) nodular melanoma and predictors of nodular melanoma versus nodular non-melanoma tumours: a multicentric collaborative study by the International Dermoscopy Society.Journal of the European Academy of Dermatology and Venereology : JEADV · 2020Article
- Peritumoral Immune Infiltrate as a Prognostic Biomarker in Thin Melanoma.Frontiers in immunology · 2020Article
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41 authors at 2 institutions in 3 countries.
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Abstract
backgroundNodular melanoma (NM) is more likely to be fatal compared with other melanoma subtypes, an effect attributed to its greater Breslow thickness.
methodsClinicopathological features of NM and superficial spreading melanoma (SSM) diagnosed in 17 centers in Europe (n = 15), the United States, and Australia between 2006 and 2015, were analyzed by multivariable logistic regression analysis, with emphasis on thin (T1 ≤ 1.0 mm) melanomas. Cox analysis assessed melanoma-specific survival. All statistical tests were two sided.
resultsIn all, 20 132 melanomas (NM: 5062, SSM: 15 070) were included. Compared with T1 SSM, T1 NM was less likely to have regression (odds ratio [OR] = 0.46, 95% confidence interval [CI] = 0.29 to 0.72) or nevus remnants histologically (OR = 0.60, 95% CI = 0.42 to 0.85), and more likely to have mitoses (OR = 1.97, 95% CI = 1.33 to 2.93) and regional metastasis (OR = 1.77, 95% CI = 1.02 to 3.05). T1 NM had a higher mitotic rate than T1 SSM (adjusted geometric mean = 2.2, 95% CI = 1.9 to 2.5 vs 1.6, 95% CI = 1.5 to 1.7 per mm2, P < .001). Cox multivariable analysis showed a higher risk for melanoma-specific death for NM compared with SSM for T1 (HR = 2.10, 95% CI = 1.24 to 3.56) and T2 melanomas (HR = 1.30, 95% CI = 1.01 to 1.68), and after accounting for center heterogeneity, the difference was statistically significant only for T1 (HR = 2.20, 95% CI = 1.28 to 3.78). The NM subtype did not confer increased risk within each stratum (among localized tumors or cases with regional metastasis).
conclusionsT1 NM (compared with T1 SSM) was associated with a constellation of aggressive characteristics that may confer a worse prognosis. Our results indicate NM is a high-risk melanoma subtype that should be considered for inclusion in future prognostic classifications of melanoma.
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