Lethal "thin" malignant melanoma. Identifying patients at risk.

Abstract:

:Thin melanomas can metastasize and be lethal. The purpose of this review was to identify negative risk factors in patients with melanomas less than 0.76 mm thick. Six hundred and eighty-one (681) such patients are reviewed in this study. Of those referred without metastatic disease (583 patients), metastases developed in 4.8% after a mean followup of 3.6 years. Of those referred with metastatic disease (98 patients), mortality was 35% after a mean followup of 5.9 years. Male patients (p less than 0.04) and patients with axial primaries (p less than 0.05) were at an increased risk of metastasis. Severe histologic regression was present in 40% of the primary lesions that metastasized and in only 17% of similar lesions that did not (p less than 0.001). Increased age was associated with increased local skin metastases, but not with increased nodal or distant metastases. A prognostic model was designed, using two clinical risk factors (axial primary site and male sex) and two histologic risk factors (Clark's Level IV and severe histologic regression). The prognostic model identified a low-risk population--women with extremity primaries--with an actuarial risk of metastasis at 10 years that was less than 3%. Patients with either (1) both clinical risk factors or (2) one clinical risk factor and one histologic risk factor were identified as high-risk patients. Their actuarial risk of metastasis was 11% at 5 years and 22% at 10 years (p = 0.0084). Identifying high-risk and low-risk patients with thin melanomas may improve guidelines for the application of adjuvant therapies to this population.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Slingluff CL Jr,Vollmer RT,Reintgen DS,Seigler HF

doi

10.1097/00000658-198808000-00004

subject

Has Abstract

pub_date

1988-08-01 00:00:00

pages

150-61

issue

2

eissn

0003-4932

issn

1528-1140

journal_volume

208

pub_type

杂志文章
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    doi:10.1097/00000658-199810000-00017

    authors: Urschel HC Jr,Razzuk MA

    更新日期:1998-10-01 00:00:00

  • Fine-needle aspiration may miss a third of all malignancy in palpable thyroid nodules: a comprehensive literature review.

    abstract:BACKGROUND:Fine-needle aspiration (FNA) is currently the primary diagnostic procedure in diagnosing thyroid malignancy and guides surgeons on patient selection for thyroidectomy for thyroid nodules. Diagnostic sensitivity is reported to be approximately 80%; however, patients with negative FNA results do not necessaril...

    journal_title:Annals of surgery

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    doi:10.1097/SLA.0b013e3180f61adc

    authors: Tee YY,Lowe AJ,Brand CA,Judson RT

    更新日期:2007-11-01 00:00:00

  • Chemical debridement of burns.

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    doi:10.1097/00000658-197410000-00032

    authors: Levenson SM,Kan D,Gruber C,Crowley LV,Lent R,Watford A,Seifter E

    更新日期:1974-10-01 00:00:00

  • Donating a Kidney to a Stranger: A Review of the Benefits and Controversies of Unspecified Kidney Donation.

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    authors: Maple H,Draper H,Gogalniceanu P,Burnapp L,Chilcot J,Mamode N

    更新日期:2020-07-01 00:00:00

  • Disease-free Survival and Local Recurrence for Laparoscopic Resection Compared With Open Resection of Stage II to III Rectal Cancer: Follow-up Results of the ACOSOG Z6051 Randomized Controlled Trial.

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    pub_type: 杂志文章,多中心研究,随机对照试验

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    authors: Fleshman J,Branda ME,Sargent DJ,Boller AM,George VV,Abbas MA,Peters WR Jr,Maun DC,Chang GJ,Herline A,Fichera A,Mutch MG,Wexner SD,Whiteford MH,Marks J,Birnbaum E,Margolin DA,Larson DW,Marcello PW,Posner MC,Read TE

    更新日期:2019-04-01 00:00:00

  • TransCarotid Revascularization with Dynamic Flow reversal versus Carotid Endarterectomy in the Vascular Quality Initiative Surveillance Project.

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    doi:10.1097/SLA.0000000000004496

    authors: Malas MB,Dakour-Aridi H,Kashyap VS,Eldrup-Jorgensen J,Wang GJ,Motaganahalli RL,Cronenwett JL,Schermerhorn ML

    更新日期:2020-09-15 00:00:00

  • A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria.

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    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0b013e3181efc656

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    更新日期:2010-12-01 00:00:00

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    journal_title:Annals of surgery

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    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究

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    pub_type: 杂志文章

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    更新日期:2006-05-01 00:00:00

  • Indications for different modes of surgical therapy in medically refractory ventricular arrhythmias.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198606000-00013

    authors: Hammon JW Jr,Echt DS,Merrill WH,Primm KR,Woosley RL,Smith RF,Roden DM,Bender HW Jr

    更新日期:1986-06-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1097/00000658-199009000-00002

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  • Long-term complications of laparotomy in Hodgkin's disease.

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    pub_type: 杂志文章,评审

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  • Intratumoral Genetic Heterogeneity in Rectal Cancer: Are Single Biopsies representative of the entirety of the tumor?

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    pub_type: 杂志文章

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  • Factors Predicting Response, Perioperative Outcomes, and Survival Following Total Neoadjuvant Therapy for Borderline/Locally Advanced Pancreatic Cancer.

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    更新日期:2021-02-01 00:00:00

  • Abdominal aneurysm and horseshoe kidney: a review.

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    pub_type: 杂志文章

    doi:10.1097/00000658-197503000-00015

    authors: Bietz DS,Merendino KA

    更新日期:1975-03-01 00:00:00

  • Surgical strategies in esophageal carcinoma with emphasis on radical lymphadenectomy.

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    pub_type: 杂志文章

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    authors: Lerut T,De Leyn P,Coosemans W,Van Raemdonck D,Scheys I,LeSaffre E

    更新日期:1992-11-01 00:00:00

  • Desmoid-type fibromatosis and pregnancy: a multi-institutional analysis of recurrence and obstetric risk.

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    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000000224

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    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000000968

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    pub_type: 杂志文章

    doi:10.1097/00000658-199110000-00012

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    更新日期:2012-04-01 00:00:00

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    更新日期:2003-06-01 00:00:00

  • Antibiotic prophylaxis in acute nonperforated appendicitis. The Danish Multicenter Study Group III.

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    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

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    authors: Bauer T,Vennits B,Holm B,Hahn-Pedersen J,Lysen D,Galatius H,Kristensen ES,Graversen P,Wilhelmsen F,Skjoldborg H

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    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/SLA.0b013e31825b35d5

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    更新日期:2012-08-01 00:00:00

  • Inhibition of tumor angiogenesis and melanoma growth by targeting vascular E-selectin.

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    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31822a72dc

    authors: Liu ZJ,Tian R,Li Y,An W,Zhuge Y,Livingstone AS,Velazquez OC

    更新日期:2011-09-01 00:00:00