Subset of Stage I Melanoma Patients ID’d With Very Low Mortality

Stage I melanoma patients with ≤1.0mm lesions show <1% mortality risk. Consider implications for treatment stratification. Read more for classification criteria.

A subset of melanoma patients with stage I lesions and negative clinical nodes with very low risk for mortality from melanoma has been identified, according to a study published online Nov. 7 in Cancer.

Megan M. Eguchi, M.P.H., from the David Geffen School of Medicine at the University of California in Los Angeles, and colleagues selected melanoma patients diagnosed in 2010 and 2011 with stage I lesions ≤1.0 mm thick and negative clinical lymph nodes from the Surveillance, Epidemiology, and End Results database. Models were developed and validated for identifying patients with a very low risk for death from melanoma within seven years.

The researchers found that a subset comprising 25 percent of the patients had a risk of <1 percent for seven-year mortality from melanoma compared with an overall seven-year mortality from melanoma of 2.5 percent. In all models, younger age at diagnosis and Clark level II were associated with a low risk for death. Associations were also seen with lower mortality for Breslow thickness less than 0.4 mm, absence of mitogenicity, absence of ulceration, and female sex. A small subset of high-risk patients was also identified, with >20 percent risk for death.

“This study suggests there is a real subset of patients with very‐low risk of melanoma death; we hope this serves as a baseline to further develop the classification criteria to establish use of the melanocytic neoplasms of low malignant potential term in clinical practice,” the authors write.

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