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September 1986, Vol 122, No. 9 >
Article | September 1986

Prognosis in Melanoma: Title and subTitle BreakWhat Have We Learned?

Howard K. Koh, MD
[+] Author Affiliations

Department of Dermatology, Medicine, and Public Health Boston University School of Medicine 75 E Concord St Boston, MA 02111


Arch Dermatol. 1986;122(9):993-994. doi:10.1001/archderm.1986.01660210043013
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Every dermatologist has faced the anxious melanoma patient who asks: "What is melanoma? What's going to happen to me? Can I be cured? When will I know if I am cured? Am I going to die?" As the incidence of melanoma continues to rise, so will the frequency of these poignant questions.

The study by Rogers et al1 in this issue of the Archives uses hazard-rate analysis to help us address some of these questions. Their long-term study of 719 consecutive patients with clinical stage I malignant melanoma examines prognosis and outcome and reaches some interesting conclusions and implications.

First, their study reemphasizes the crucial point that early melanoma can be cured. Although physicians are rightfully cautious when applying the term cure to any patient with cancer, it appears that patients who survive ten years after definitive surgery have little to no chance of dying from recurrent melanoma. In

REFERENCES

1 +
Rogers GS, Kopf AW, Rigel DS, et al:  Hazard-rate analysis in stage I malignant melanoma . Arch Dermatol 1986;;122:999-1002.
2 +
Koh H, Sober A, Fitzpatrick T:  Late recurrence of cutaneous malignant melanoma . JAMA 1984;;251:1859-1862.
3 +
Shaw H, Beathe C, McCarthy W, et al:  Late relapse from cutaneous stage I malignant melanoma . Arch Surg 1985;;120:1155-1160.
4 +
Rutquist L, Wallgren A, Nilsson B:  Is breast cancer a curable disease? Cancer 1984;;53:1793-1800.
5 +
Brinkley D, Haybittle J:  Long-term survival of women with breast cancer . Lancet 1984;;1:1118.
6 +
Duncan W, Kerr G:  The curability of breast cancer . Br Med J 1976;;2:781-783.
7 +
Day C, Mihm M, Lew R, et al:  Cutaneous malignant melanoma: Prognostic guidelines for physicians and patients . CA 1982;;32:113-122.
8 +
Day CL, Mihm MC, Sober AJ, et al:  Predictors of late deaths among patients with clinical stage I melanoma who have not had bony or visceral metastases within the first five years after diagnosis . J Am Acad Dermatol 1983;;8:864-868.
9 +
Day C, Harrist T, Lew R, et al:  Classification of malignant melanoma according to the histologic morphology of melanoma nodules . J Dermatol Surg Oncol 1982;;8:874-900.
10 +
Wilder H, Paul E:  Malignant melanoma of the choroid and ciliary body: A study of 2533 cases . Mil Med 1951;;109:370-378.
11 +
Poste G, Fidler J:  The pathogenesis of cancer metastasis . Nature 1980;;283:139-146.
12 +
Schnipper L:  Clinical implications of tumor-cell heterogeneity . N Engl J Med 1986;;314:1423-1431.
13 +
Scanlon T:  The process of metastasis . Cancer 1985;;55:1163-1166.
14 +
Koh H, Sober A, Harmon D, et al:  Adjuvant therapy in cutaneous malignant melanoma: A critical review . Med Pediatr Oncol 1986;;13:244-260.
15 +
Kelly J, Blois MS, Sagebiel R:  Frequency and duration of patient follow-up after treatment of a primary malignant melanoma . J Am Acad Dermatol 1985;;13:756-760.
16 +
Lew R, Day C, Harrist T, et al:  Multivariate analysis . JAMA 1983;;249:641-643.
17 +
Balch C, Wilerson J, Murad T, et al:  The prognostic significance of ulceration of cutaneous melanoma . Cancer 1980;;45:3012-3017.
18 +
Balch C, Milton C: Cutaneous Melanoma . New York, JB Lippincott, 1985;.
19 +
Cancinelli N, Vaglini M, Bufalino R, et al:  BANS: A cutaneous region with no prognostic significance in patients with melanoma . Cancer 1986;;57:441-444.
20 +
Day C, Lew R, Harrist T:  Malignant melanoma prognostic factors 4: Ulceration width . J Dermatol Surg Oncol 1984;;10:23-24.
21 +
Gromet M, Epstein WL, Blois MS:  The regression thin malignant melanoma: A distinctive lesion with metastatic potential . Cancer 1978;;42:2282.
22 +
Elder D, Guerry D, Van Horn M:  The role of lymph node dissection for clinical stage I malignant melanoma of intermediate thickness (1.51 to 3.99 mm) . Cancer 1985;;56:413-418.
23 +
Koh H, Sober A, Day C, et al:  Prognosis of clinical stage I melanoma patients with positive elective regional node dissections . J Clin Oncol , in press.
24 +
Schmoeckel C, Braun-Falco O:  The prognostic index in malignant melanoma . Arch Dermatol 1978;;114:871-878.
25 +
Rosenberg S, Lotze M, Muul L, et al:  Observations on the systemic administration of autologous lymphokine-activated killer cells and recombinant interleukin-2 to patients with metastatic cancer . N Engl J Med 1985;;313:1485-1492.
26 +
Elder D, Green M, Guery D, et al:  The dysplastic nevus syndrome . Am J Dermatopathol 1982;;4:455-460.
27 +
Ackerman A:  No one should die of malignant melanoma . J Am Acad Dermatol 1985;;12:115-116.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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1 +
Rogers GS, Kopf AW, Rigel DS, et al:  Hazard-rate analysis in stage I malignant melanoma . Arch Dermatol 1986;;122:999-1002.
2 +
Koh H, Sober A, Fitzpatrick T:  Late recurrence of cutaneous malignant melanoma . JAMA 1984;;251:1859-1862.
3 +
Shaw H, Beathe C, McCarthy W, et al:  Late relapse from cutaneous stage I malignant melanoma . Arch Surg 1985;;120:1155-1160.
4 +
Rutquist L, Wallgren A, Nilsson B:  Is breast cancer a curable disease? Cancer 1984;;53:1793-1800.
5 +
Brinkley D, Haybittle J:  Long-term survival of women with breast cancer . Lancet 1984;;1:1118.
6 +
Duncan W, Kerr G:  The curability of breast cancer . Br Med J 1976;;2:781-783.
7 +
Day C, Mihm M, Lew R, et al:  Cutaneous malignant melanoma: Prognostic guidelines for physicians and patients . CA 1982;;32:113-122.
8 +
Day CL, Mihm MC, Sober AJ, et al:  Predictors of late deaths among patients with clinical stage I melanoma who have not had bony or visceral metastases within the first five years after diagnosis . J Am Acad Dermatol 1983;;8:864-868.
9 +
Day C, Harrist T, Lew R, et al:  Classification of malignant melanoma according to the histologic morphology of melanoma nodules . J Dermatol Surg Oncol 1982;;8:874-900.
10 +
Wilder H, Paul E:  Malignant melanoma of the choroid and ciliary body: A study of 2533 cases . Mil Med 1951;;109:370-378.
11 +
Poste G, Fidler J:  The pathogenesis of cancer metastasis . Nature 1980;;283:139-146.
12 +
Schnipper L:  Clinical implications of tumor-cell heterogeneity . N Engl J Med 1986;;314:1423-1431.
13 +
Scanlon T:  The process of metastasis . Cancer 1985;;55:1163-1166.
14 +
Koh H, Sober A, Harmon D, et al:  Adjuvant therapy in cutaneous malignant melanoma: A critical review . Med Pediatr Oncol 1986;;13:244-260.
15 +
Kelly J, Blois MS, Sagebiel R:  Frequency and duration of patient follow-up after treatment of a primary malignant melanoma . J Am Acad Dermatol 1985;;13:756-760.
16 +
Lew R, Day C, Harrist T, et al:  Multivariate analysis . JAMA 1983;;249:641-643.
17 +
Balch C, Wilerson J, Murad T, et al:  The prognostic significance of ulceration of cutaneous melanoma . Cancer 1980;;45:3012-3017.
18 +
Balch C, Milton C: Cutaneous Melanoma . New York, JB Lippincott, 1985;.
19 +
Cancinelli N, Vaglini M, Bufalino R, et al:  BANS: A cutaneous region with no prognostic significance in patients with melanoma . Cancer 1986;;57:441-444.
20 +
Day C, Lew R, Harrist T:  Malignant melanoma prognostic factors 4: Ulceration width . J Dermatol Surg Oncol 1984;;10:23-24.
21 +
Gromet M, Epstein WL, Blois MS:  The regression thin malignant melanoma: A distinctive lesion with metastatic potential . Cancer 1978;;42:2282.
22 +
Elder D, Guerry D, Van Horn M:  The role of lymph node dissection for clinical stage I malignant melanoma of intermediate thickness (1.51 to 3.99 mm) . Cancer 1985;;56:413-418.
23 +
Koh H, Sober A, Day C, et al:  Prognosis of clinical stage I melanoma patients with positive elective regional node dissections . J Clin Oncol , in press.
24 +
Schmoeckel C, Braun-Falco O:  The prognostic index in malignant melanoma . Arch Dermatol 1978;;114:871-878.
25 +
Rosenberg S, Lotze M, Muul L, et al:  Observations on the systemic administration of autologous lymphokine-activated killer cells and recombinant interleukin-2 to patients with metastatic cancer . N Engl J Med 1985;;313:1485-1492.
26 +
Elder D, Green M, Guery D, et al:  The dysplastic nevus syndrome . Am J Dermatopathol 1982;;4:455-460.
27 +
Ackerman A:  No one should die of malignant melanoma . J Am Acad Dermatol 1985;;12:115-116.

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