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Prognostic Evaluation of Cutaneous Malignant Melanoma Based on the pTNM Classification
Author(s) -
Sugihara Tsuneki,
Yoshida Tetsunori,
Kokubu Ichiro,
Chiba Osamu,
Ohura Takehiko,
Ohkawara Akira
Publication year - 1994
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/j.1346-8138.1994.tb03318.x
Subject(s) - stage (stratigraphy) , medicine , melanoma , gastroenterology , survival rate , disease , surgery , biology , paleontology , cancer research
The prognoses of 100 consecutive melanoma patients were analyzed on the basis of Breslow's thickness and Clark's levels as well as according to stage employing the 1987 UICC pTNM classification. Among patients with lesions ≦1.50 mm thick, the 10‐year survival rate was 100% for both pT1 (n=13) and pT2 (n=6) disease, 73.4% for pT3a disease (n=26), 62.2% for pT3b disease (n=15), 69.3% for pT3 (n=41) disease, and 38.7% for pT4 disease (n=38). Significant differences in survival were found between the pT4 group and the pT1/pT3a or pT3 groups. The 10‐year survival rate was 100% for level II (n=13) and level III (n=13) disease, 58.3% for level IV (n=46) disease, and 34.5% for level V (n=26) disease. Significant differences were found between level V and other levels. The survival rate at 10 years was 100% for stage I (n=18), 63.3% for stage II (n=24), and 52.5% for stage III (n=55). In stage IV (n=3), there was only one patient who survived for 42 months. There were significant differences in survival among all stages except I and II. The 10‐year survival rate in 3 subgroups of stage III was 58.9% for pT4pN0M0 patients (n=14), 63.2% for pT,pN1M0 patients (n=31), and 20% for pT,pN2M0 patients (n=10). Significant differences were found between the pT,pN1M0 and pT,pN2M0 subgroups. These findings indicate that the survival of pT1, pT2 and stage I patients is extremely good. In contrast, the prognosis of patients with pT3, pT3b or pT4, and stage III or IV disease is significantly poor. Within stage III, the prognosis of the pT,pN2M0 subgroup is significantly poor, and the classification of pN2 patients may need to be reconsidered.