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Objective histopathologic grading of cutaneous malignant melanomas by stereologic estimation of nuclear volume. Prediction of survival and disease‐free period
Author(s) -
Brandt Sørensen Flemming
Publication year - 1990
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19900501)63:9<1784::aid-cncr2820630922>3.0.co;2-9
Subject(s) - medicine , grading (engineering) , melanoma , malignancy , proportional hazards model , pathology , oncology , nuclear medicine , dermatology , civil engineering , cancer research , engineering
Modern stereologic techniques enable unbiased and shape‐independent estimation of the three‐dimensional nuclear volume (v̄ v ). This study investigates the prognostic impact of v̄ v in 47 patients with malignant melanomas (10 years of follow‐up) and compares v̄ v to traditional prognostic parameters and two‐dimensional morphometric estimates. The averaged v̄ v was 226 μm 3 and 457 μm 3 in Stage I and II melanomas, respectively. The v̄ v was significantly increased in the case of ulceration, nodular melanoma, and Clark' level gt; III. The v̄ v showed only poor correlation to two‐dimensional morphometric estimates. Cox regression analysis indicated v̄ v to possess excellent prognostic information, only rivaled by tumor ulceration, the latter being a 100% predictor of metastatic spread. Histologic type, Clark' level of invasion, tumor thickness (according to Breslow), and patient sex were without independent prognostic significance, which may be due to attributes of the small data base. It is concluded that v̄ v may be a powerful prognostic indicator in cutaneous melanomas, suitable for objective malignancy grading. The clinical and prognostic value of nuclear v̄ v needs further investigation in a larger and contemporary series of patients with malignant melanomas.