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Prognostic Factors in Cutaneous Melanoma

  • Chapter
Pathology of Melanocytic Nevi and Melanoma

Abstract

As with all malignant tumors, the biological potential of any given primary melanoma is encrypted in the genome and epigenetic elements of the clone(s) of malignant cells giving rise to that tumor, and the expression of that potential is governed by currently obscure mechanisms of stochastic probability. At present, the code is indecipherable at the systems biology level that coordinately executes the tumor’s behavior within the host. Occasional thin, microinvasive melanomas with seemingly favorable attributes are sometimes rapidly fatal, and thick, bulky melanomas exist that despite all pessimistic expectations remain clinically inert over 5, 10, or more years of observation. Because melanoma is a heterogeneous disease and because the actual malignant potential of any given melanocytic tumor is thus opaque, one does what human societies have done since time immemorial: one searches for physical signs in nature. The process of resorting to such surrogate phenotypic prognostic markers/signs allows a categorization of tumors, which in turn generates classification schema that enable an understanding of the disease and which, it is hoped, may represent at best, albeit rudimentary, approximation of the neoplastic genotype and its biological potential.

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Authors and Affiliations

  1. Division of Dermatology, Department of Medicine, School of Medicine, 356524, University of Washington, Seattle, WA, 98195, USA

    Michael W. Piepkorn MD, PhD

  2. Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at the University of California, Los Angeles, USA

    Raymond L. Barnhill MD, MSc

  3. Jonsson Comprehensive Cancer Center, 10833 Le Conte Ave., AS-370 CHS, Los Angeles, CA, 90095, USA

    Raymond L. Barnhill MD, MSc

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  1. Michael W. Piepkorn MD, PhD
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  2. Raymond L. Barnhill MD, MSc
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Correspondence to Michael W. Piepkorn MD, PhD .

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Editors and Affiliations

  1. UCLA and Jonsson Comprehensive Cancer Center at UCLA, Los Angeles, California, USA

    Raymond L. Barnhill

  2. University of Washington and Dermatopathology Northwest PLLC, Bellevue, Washington, USA

    Michael W. Piepkorn

  3. Memorial Sloan Kettering Cancer Center, New York, New York, USA

    Klaus J. Busam

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Piepkorn, M.W., Barnhill, R.L. (2014). Prognostic Factors in Cutaneous Melanoma. In: Barnhill, R., Piepkorn, M., Busam, K. (eds) Pathology of Melanocytic Nevi and Melanoma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38385-4_14

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