Evidence map›Paper›PMID 36855833›Full record

ArticleJournal of the European Academy of Dermatology and Venereology : JEADV2023

In vivo reflectance confocal microscopy can detect the invasive component of lentigo maligna melanoma: Prospective analysis and case-control study.

Bruna Melhoranse Gouveia, Giuliana Carlos, Andreanne Wadell, Christoph Sinz, Tasnia Ahmed, Serigne N Lo, Robert V Rawson, Peter M Ferguson, Richard A Scolyer, Pascale Guitera

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the European Academy of Dermatology and Venereology : JEADV, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 15 citations in OpenAlex.

  1. International Dermoscopy Society consensus recommendations for the management of lentigo maligna.Journal of the European Academy of Dermatology and Venereology : JEADV · 2026
    Review
  2. Review
  3. A Clinical Perspective on Melanoma Overdiagnosis.The Australasian journal of dermatology · 2025
    Review
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 2 countries.

Bruna Melhoranse GouveiaMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-6322-5675
Giuliana CarlosSydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Andreanne WadellMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
Christoph SinzSydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Tasnia AhmedMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
Serigne N LoMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0001-5092-5544
Robert V RawsonMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
Peter M FergusonMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
Richard A ScolyerMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-8991-0013
Pascale GuiteraMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
The University of Sydney · AURoyal Prince Alfred Hospital · AU

Funding

Melanoma Institute AustraliaMetaOptima Technology Incl., Hoffmann-La Roche Ltd, Evaxion, Provectus Biopharmaceuticals Australia, Qbiotics, Novartis, Merck Sharp & Dohme, NeraCare, AMGEN Inc., Bristol-Myers Squibb, Myriad Genetics, GlaxoSmithKline. N/ANHMRC Practitioner Fellowship APP1141295
6 · The paper itself

Abstract

backgroundLentigo maligna (LM), a form of melanoma in situ, has no risk of causing metastasis unless dermal invasive melanoma (LMM) supervenes. Furthermore, the detection of invasion impacts prognosis and management.

objectiveTo assess the accuracy of RCM for the detection of invasion component on LM/LMM lesions.

methodsIn the initial case-control study, the performance of one expert in detecting LMM at the time of initial RCM assessment of LM/LMM lesions was recorded prospectively (n = 229). The cases were assessed on RCM-histopathology correlation sessions and a panel with nine RCM features was proposed to identify LMM, which was subsequently tested in a subset of initial cohort (n = 93) in the matched case-control study by two blinded observers. Univariable and multivariable logistic regression models were performed to evaluate RCM features predictive of LMM. Reproducibility of assessment of the nine RCM features was also evaluated.

resultsA total of 229 LM/LMM cases evaluated by histopathology were assessed blindly and prospectively by an expert confocalist. On histopathology, 210 were LM and 19 were LMM cases. Correct identification of an invasive component was achieved for 17 of 19 LMM cases (89%) and the absence of a dermal component was correctly diagnosed in 190 of 210 LM cases (90%). In the matched case-control (LMM n = 35, LM n = 58), epidermal and junctional disarray, large size of melanocytes and nests of melanocytes were independent predictors of LMM on multivariate analysis. The interobserver analysis demonstrated that these three features had a fair reproducibility between the two investigators (K = 0.4). The multivariable model including those three features showed a high predictive performance AUC = 74% (CI 95% 64-85%), with sensitivity of 63% (95% CI 52-78%) and specificity of 79% (CI 95% 74-88%), and likelihood ratio of 18 (p-value 0.0026).

conclusionThree RCM features were predictive for identifying invasive melanoma in the background of LM.

Indexed as

Hutchinson's Melanotic FreckleMelanomaSkin NeoplasmsCase-Control StudiesCutaneous Malignant MelanomaHumansMicroscopy, ConfocalReproducibility of Results

Identifiers

PMID36855833
PMCPMC10946995
OpenAlexW4322719939

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.