Prognosis of thick cutaneous melanoma of the trunk and extremity Journal Article


Authors: Coit, D.; Sauven, P.; Brennan, M.
Article Title: Prognosis of thick cutaneous melanoma of the trunk and extremity
Abstract: • The records of 129 patients with thick cutaneous melanoma of the trunk or extremity treated at Memorial Sloan-Kettering Cancer Center, New York, NY, between 1974 and 1984 were reviewed with the aim of defining prognostic variables. All primary lesions invaded subcutaneous fat, were Clark level V, or of a Breslow thickness of 4.0 mm or greater. Treatment in all cases was by wide excision with or without split-thickness skin graft; all patients underwent regional lymph node dissection. Overall survival rate for the group was 47% at 5 years and 36% at 10 years. Factors independently predictive of survival were pathologic negative nodes (71% at 5 years compared with 28% for pathologic positive nodes) and extremity site (58% at 5 years compared with 33% for truncal site). Patients with node-negative thick cutaneous melanoma of the extremity had a 5-year survival rate of 82%. Patients with node-positive truncal thick cutaneous melanoma had a 5-year survival rate of only 8%. There was no difference between the 5-year survival rate of patients with nodenegative truncal thick cutaneous melanoma, 52%, and patients with node-positive thick cutaneous melanoma of the extremity, 42%. Nearly half of the patients with thick cutaneous melanoma of the extremity and trunk present with locoregional disease, at a stage when an aggressive surgical approach is warranted. Prognostic variables of pathologic nodal status and site identify patients at risk for early systemic failure. © 1990, American Medical Association. All rights reserved.
Keywords: adult; survival analysis; major clinical study; conference paper; follow-up studies; lymphatic metastasis; neoplasm staging; lymph node excision; melanoma; metastasis; neoplasm recurrence, local; skin neoplasms; age factors; age; limb; neoplasm invasiveness; sex factors; skin graft; leg; skin transplantation; fatality; arm; trunk; prognosis; human; male; female; priority journal; support, u.s. gov't, p.h.s.; skin melanoma
Journal Title: Archives of Surgery
Volume: 125
Issue: 3
ISSN: 0004-0010
Publisher: American Medical Association  
Date Published: 1990-03-01
Start Page: 322
End Page: 326
Language: English
DOI: 10.1001/archsurg.1990.01410150044009
PUBMED: 2306180
PROVIDER: scopus
DOI/URL:
Notes: Article -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Murray F Brennan
    1059 Brennan
  2. Daniel Coit
    542 Coit