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A Pathologist’s Perspective on Prognostic Features of Malignant Melanoma

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Melanoma

Part of the book series: Current Clinical Oncology ((CCO))

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Abstract

Today, at the beginning of the twenty-first century, most dermatologists, surgeons, and oncologists that deal with melanoma patients have a simple view of pigment lesion pathology. It consists of benign nevus, including dysplastic nevus, in situ melanoma, and invasive melanoma. These are regarded as discrete entities with only minimal reference to a sequence of change from dysplasia to melanoma. Once invasive melanoma is diagnosed, the only additional necessary information is tumor thickness and the presence or absence of ulceration (1,2). However, from a pathologist’ s point of view, the process of changing from a premalignant dysplasia to malignant melanoma is not that simple. A brief history of the past, present, and future of pigment lesion pathology is in order.

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References

  1. Balch CM, et al. A new American Joint Committee on Cancer staging system for cutaneous melanoma. Cancer 2000; 88: 1484–1491.

    Article  PubMed  CAS  Google Scholar 

  2. Buzaid A, et al. Critical analysis of the current American Joint Committee on Cancer Staging System for cutaneous melanoma and proposal of a new staging system. J Clin Oncol 1997; 15: 1039–1051.

    PubMed  CAS  Google Scholar 

  3. Clark WH Jr, et al. The developmental biology of primary human malignant melanomas. Semin Oncol 1975; 2: 83–103.

    PubMed  Google Scholar 

  4. Clark WH Jr, et al. A study of tumor progression: the precursor lesions of superficial spreading and nodular melanoma. Hum Pathol 1984; 15: 1147–1165.

    Article  PubMed  Google Scholar 

  5. Clark WH Jr, Elder DE, Van Horn M. The biologic forms of malignant melanoma. Hum Pathol 1986; 17: 443–450.

    Article  PubMed  Google Scholar 

  6. Elder D, et al. Invasive malignant melanomas lacking competence for metastasis. Am J Dermatopathol 1984; 6 (Suppl 1): 55–61.

    PubMed  Google Scholar 

  7. Reed R.I. A classification of melanocytic dysplasias and malignant melanomas. Am J Dermatopathol 1984; 6 (Suppl): 195–206.

    Article  PubMed  Google Scholar 

  8. Reed RJ. Melanoma in situ: images, segments, appellations, and implications. Hum Pathol 1998; 29: 1–3.

    Article  PubMed  CAS  Google Scholar 

  9. Reed RJ. Dimensionalities: borderline and intermediate melanocytic neoplasia. Hum Pathol 1999; 30: 521–524.

    Article  PubMed  CAS  Google Scholar 

  10. Reed R. The Reed patch, whither part 1, real and virtual images. World Wide Web 1999; October (http://www.xmission.com/-bweems/rjrpatch2.htm).

    Google Scholar 

  11. Reed R. The Reed patch, whither, part 2, the soil. World Wide Web 1999; November (http: //www.xmission.com/-bweems/whither11025.html).

    Google Scholar 

  12. Reed R. The Reed patch, whither, part 3, the nature of seeds, anatomic boundaries, and taking root. World Wide Web 2000; January (http://www.xmission.com/-.bweems/whither31130.htm).

    Google Scholar 

  13. Reed RJ. The Reed patch (a neglected garden). World Wide Web 2000 (http://www. xmission.com/-bweems/rjrpatch2.htm).

    Google Scholar 

  14. Clark W Jr, et al. Model predicting survival in stage I melanoma based on tumor progression. J Natl Cancer Inst 1989; 81: 1893–1904.

    Article  PubMed  Google Scholar 

  15. McDermott N, et al. Identification of vertical growth phase in malignant melanoma. A study of interobserver agreement. Am J Clin Pathol 1998; 110: 753–757.

    PubMed  CAS  Google Scholar 

  16. Reed RJ. Minimal deviation melanoma. Monogr Pathol 1988: 110–152.

    Google Scholar 

  17. Reed R. Minimal deviation melanoma. Hum Pathol 1990; 21: 1206–1211.

    Article  PubMed  CAS  Google Scholar 

  18. Breslow A. Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma. Ann Surg 1970; 172: 902–908.

    Article  PubMed  CAS  Google Scholar 

  19. Breslow A. Tumor thickness, level of invasion and node dissection in stage I cutaneous melanoma. Ann Surg 1975; 182: 572–575.

    Article  PubMed  CAS  Google Scholar 

  20. Breslow A. Prognosis in cutaneous melanoma: tumor thickness as a guide to treatment. Pathol Annu 1980; 15: 1–22.

    PubMed  CAS  Google Scholar 

  21. Vollmer R. Malignant melanoma. A multivariate analysis of prognostic factors. Pathol Annu 1989; 24: 383–407.

    PubMed  Google Scholar 

  22. Balch CM, et al. Long-term results of a multi-institutional randomized trial comparing prognostic factors and surgical results for intermediate thickness melanomas (1.0 to 4.0 mm). Ann Surg Oncol 2000; 7: 87–97.

    Article  PubMed  CAS  Google Scholar 

  23. Reed R. Nevoid melanoma and index. Morphologic ambiguities: their impact on the interpretation of histologic patterns of melanocytic lesions. 2000; (http://www.pathology-skinrjreed.com/mihml.html.

    Google Scholar 

  24. Tuthill R, et al. Risk assessment in localized primary cutaneous melanoma: a Southwest Oncology Group study evaluating nine factors and a test of the Clark logistic regression prediction model. Mod Pathol 2000; 13: 69a.

    Google Scholar 

  25. Stadelmann W, et al. Prognostic factors that influence melanoma outcome. In: Balch CM, et al., eds., Cutaneous Melanoma, Quality Medical Publishing, St. Louis, MO, 1998, pp. 11–35.

    Google Scholar 

  26. Vollmer RT, Seigler HF. Using a continuous transformation of the Breslow thickness for prognosis in cutaneous melanoma. Am J Clin Pathol 2001; 115: 205–212.

    Article  PubMed  CAS  Google Scholar 

  27. Menhert J, Heard J. Staging of malignant melanomas by depth of invasion. Am J Surg 1965; 110: 168.

    Article  Google Scholar 

  28. Clark WH Jr, et al. The histogenesis and biologic behavior of primary human malignant melanomas of the skin. Cancer Res 1969; 29: 705.

    PubMed  Google Scholar 

  29. Clemente C, et al. Prognostic value of tumor infiltrating lymphocytes in the vertical growth phase of primary cutaneous melanoma. Cancer 1996; 77: 1303–1310.

    Article  PubMed  CAS  Google Scholar 

  30. Schmoeckel C, Braun-Falco O. Prognostic index in malignant melanoma. Arch Dermatol 1978; 114: 871–873.

    Article  PubMed  CAS  Google Scholar 

  31. Alvarez-Mendoza A, et al. Malignant melanoma in children and congenital melanocytic nevi: DNA content and cell cycle analysis by flow cytometry. Pediatr Dev Pathol 2001; 4: 73–81.

    Article  PubMed  CAS  Google Scholar 

  32. Coon J, Weinstein R. Evaluation of solid tumors by flow cytometry: methods and interpretation. In: Coon J, Weinstein R, eds., Diagnostic Flow Cytometry, Williams and Wilkins, Baltimore, 1991, pp. 115–134.

    Google Scholar 

  33. Henrique R, et al. Prognostic value of Ki-67 expression in localized cutaneous malignant melanoma. JAm Acad Dermatol 2000; 43: 991–1000.

    Article  CAS  Google Scholar 

  34. Moretti S, et al. Correlation of Ki-67 expression in cutaneous primary melanoma with prognosis in a prospective study: different correlation according to thickness. JAm Acad Dermatol 2001; 44: 188–192.

    Article  CAS  Google Scholar 

  35. Ramsay JA, et al. MIB-1 proliferative activity is a significant prognostic factor in primary thick cutaneous melanomas. J Invest Dermatol 1995; 105: 22–26.

    Article  PubMed  CAS  Google Scholar 

  36. Vuhahula E, Straume O, Akslen LA. Frequent loss of p16 protein expression and high proliferative activity (Ki-67) in malignant melanoma from black Africans. Anticancer Res 2000; 20: 4857–4862.

    PubMed  CAS  Google Scholar 

  37. Neitzel L, et al. Angiogenesis correlates with metastasis in melanoma. Ann Surg Oncol 1999; 6: 70–74.

    Article  PubMed  CAS  Google Scholar 

  38. Weyers W, et al. Classification of cutaneous malignant melanoma-a reassessment of histopathologic criteria for the distinction of different types. Cancer 1999; 86: 288–299.

    Article  PubMed  CAS  Google Scholar 

  39. Braitman L, Davidoff F. Predicting clinical states in individual patients. Ann Intern Med 1996; 125: 406–412.

    PubMed  CAS  Google Scholar 

  40. Rowley M, Cockerell C. Reliability of prognostic models in malignant melanoma. Am J Dermatopathol 1991; 13: 431–437.

    Article  PubMed  CAS  Google Scholar 

  41. Schmoeckel C, Braun-Falco O. Prognostic index in malignant melanoma. Arch Dermatol 1978; 114: 871–873.

    Article  PubMed  CAS  Google Scholar 

  42. Schuchter L, et al. A prognostic model for predicting 10-year survival in patients with primary melanoma. Ann Intern Med 1996; 125: 369–375.

    PubMed  CAS  Google Scholar 

  43. Halpern A, Schuchter L. Prognostic models in melanoma. Semin Oncol 1997; 24(Suppl 4): S4–2-S4–7.

    Google Scholar 

  44. Sahin S, et al. Predicting ten-year survival of patients with primary cutaneous melanoma. Corroboration of a prognostic model. Cancer 1997; 80: 1426–1431.

    Article  PubMed  CAS  Google Scholar 

  45. MacKie R, et al. Prognostic models for subgroups of melanoma patients from the Scottish melanoma group database 1979–86, and their subsequent validation. Br J Cancer 1995; 71: 173–176.

    Article  PubMed  CAS  Google Scholar 

  46. MacKie RM. Malignant melanoma: clinical variants and prognostic indicators. Clin Exp Dermatol 2000; 25: 471–475.

    Article  PubMed  CAS  Google Scholar 

  47. Aitchison T, et al. Prognostic trees to aid prognosis in patients with cutaneous malignant melanoma. Br Med J 1995; 311: 1536–1539.

    Article  CAS  Google Scholar 

  48. Soong S-J. A computerized mathematical model and scoring system for predicting outcome in melanoma patients. In: Balch CM, et al., eds., Cutaneous Melanoma, J.B. Lippincott, Philadelphia, 1985, pp. 353–367.

    Google Scholar 

  49. Soong S-J, et al. Predicting survival and recurrence in localized melanoma: a multivariate approach. World J Surg 1992; 16: 191–195.

    Article  PubMed  CAS  Google Scholar 

  50. Soong S-J. A computerized mathematical model and scoring system for predicting outcome in patients with localized melanoma. In: Balch CM, Houghton A, Sober AJ, eds., Cutaneous Melanoma, J.B. Lippincott, Philadelphia, 1992, pp. 200–212.

    Google Scholar 

  51. Soong S-J, Weiss H. Predicting outcome in patients with localized melanoma. In: Balch CM, et al., eds., Cutaneous Melanoma, Quality Medical Publishing, Inc, St. Louis, MO, 1998.

    Google Scholar 

  52. Vollmer RT, Seigler HF. A model for pretest probability of lymph node metastasis from cutaneous melanoma. Am J Clin Pathol 2000; 114: 875–879.

    Article  PubMed  CAS  Google Scholar 

  53. Treseler P, Tauchi P. Sentinel lymph node hypotheses and the role of pathologic analysis. Surg Clin North Am 2000; 80: 1695–1719.

    CAS  Google Scholar 

  54. Yu LL, et al. Detection of microscopic melanoma metastases in sentinel lymph nodes. Cancer 1999; 86: 617–627.

    Article  PubMed  CAS  Google Scholar 

  55. Messina JL, et al. Pathologic examination of the sentinel lymph node in malignant melanoma. Am J Surg Pathol 1999; 23: 686–690.

    Article  PubMed  CAS  Google Scholar 

  56. Cochran AJ. Surgical pathology remains pivotal in the evaluation of “sentinel” lymph nodes. Am J Surg Pathol 1999; 23: 1169–1172.

    Article  PubMed  CAS  Google Scholar 

  57. Cochran AJ. Melanoma metastases through the lymphatic system. Surg Clin North Am 2000; 80: 1683–1693.

    CAS  Google Scholar 

  58. Cibull M. Handling sentinel lymph node biopsy specimens. A work in progress. Arch Pathol Lab Med 1999; 123: 620–621.

    PubMed  CAS  Google Scholar 

  59. Blaheta HJ, et al. Detection of melanoma micrometastasis in sentinel nodes by reverse transcription-polymerase chain reaction correlates with tumor thickness and is predictive of micrometastatic disease in the lymph node basin. Am J Surg Pathol 1999; 23: 822–828.

    Article  PubMed  CAS  Google Scholar 

  60. McMasters K, et al. Clinical relevance of molecular staging for melanoma-comparison of RT-PCR and immunohistochemistry staining in sentinel lymph nodes of patients with melanoma-discussion. Ann Surg 2000; 231: 801–803.

    Article  Google Scholar 

  61. Korabiowska M, et al. Prognostic significance of newly defined ploidy related parameters in melanoma. Anticancer Res 2000; 20: 1685–1690.

    PubMed  CAS  Google Scholar 

  62. Haybittle J, Yuen P, Machin D. Multiple comparisons in disease mapping. Stat Med 1995; 14: 2503–2505.

    Article  PubMed  CAS  Google Scholar 

  63. Nelson MA, et al. Chromosome abnormalities in malignant melanoma: clinical significance of nonrandom chromosome abnormalities in 206 cases. Cancer Genet Cytogenet 2000; 122: 101–109.

    Article  PubMed  CAS  Google Scholar 

  64. Wiltshire R, et al. Direct visualization of the clonal progression of primary cutaneous melanoma: application of tissue microdissection and comparative genomic hybridization. Cancer Res 1995; 55: 3954–3957.

    PubMed  CAS  Google Scholar 

  65. Clark E, et al. Genomic analysis of metastasis reveals an essential role for RhoC. Nature 2000; 406: 532–535.

    Article  PubMed  CAS  Google Scholar 

  66. Bittner M, et al. Molecular classification of cutaneous malignant melanoma by gene expression profiling. Nature 2000; 406: 536–540.

    Article  PubMed  CAS  Google Scholar 

  67. Hedenfalk I, et al. Gene-expression profiles in hereditary breast cancer. N Engl J Med 2001; 344: 539–548.

    Article  PubMed  CAS  Google Scholar 

  68. Miracco C, et al. Detection of telomerase activity and correlation with mitotic and apoptotic indices, Ki-67 and expression of cyclins D1 and A in cutaneous melanoma. Int J Cancer 2000; 88: 411–416.

    Article  PubMed  CAS  Google Scholar 

  69. Glaessl A, et al. Increase in telomerase activity during progression of melanocytic cells from melanocytic naevi to malignant melanomas. Arch Dermatol Res 1999; 291: 81–87.

    Article  PubMed  CAS  Google Scholar 

  70. Rudolph P, et al. Telomerase activity in melanocytic lesions-a potential marker of tumor biology. Am J Pathol 2000; 156: 1425–1432.

    Article  PubMed  CAS  Google Scholar 

  71. Yang P, Becker D. Telomerase activity and expression of apoptosis and anti-apoptosis regulators in the progression pathway of human melanoma. Int J Oncol 2000; 17: 913–919.

    PubMed  CAS  Google Scholar 

  72. Rofstad EK, Halsor EF. Vascular endothelial growth factor, interleukin 8, platelet-derived endothelial cell growth factor, and basic fibroblast growth factor promote angiogenesis and metastasis in human melanoma xenografts. Cancer Res 2000; 60: 4932–4938.

    PubMed  CAS  Google Scholar 

  73. Vacca A, et al. Angiogenesis and anti-angiogenesis in human neoplasms. Recent developments and the therapeutic prospects. Ann Ital Med Int 2000; 15: 17–19.

    Google Scholar 

  74. Achen MG, et al. Localization of vascular endothelial growth factor-D in malignant melanoma suggests a role in tumour angiogenesis. J Pathol 2001; 193: 147–154.

    Article  PubMed  CAS  Google Scholar 

  75. Maniotis AJ, et al. Vascular channel formation by human melanoma cells in vivo and in vitro: vasculogenic mimicry. Am J Pathol 1999; 155: 739–752.

    Article  PubMed  CAS  Google Scholar 

  76. Lin EY, et al. Angiogenesis and vascular growth factor receptor expression in malignant melanoma. Plast Reconstr Surg 1999; 104: 1666–1674.

    Article  PubMed  CAS  Google Scholar 

  77. Chaplain MAJ. Mathematical modelling of angiogenesis. J Neurooncol 2000; 50: 37–51.

    Article  PubMed  CAS  Google Scholar 

  78. Hunter J, et al. Chromosomal localization and genomic characterization of the mouse melastatin gene (MLSN-1). Genomics 1998; 54: 116–123.

    Article  PubMed  CAS  Google Scholar 

  79. Duncan LM, et al. Melastatin expression and prognosis in cutaneous malignant melanoma. J Clin Oncol 2001; 19: 568–576.

    PubMed  CAS  Google Scholar 

  80. Duncan LM, et al. Down-regulation of the novel gene melastatin correlates with potential for melanoma metastasis. Cancer Res 1998; 58: 1515–1520.

    PubMed  CAS  Google Scholar 

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Authors
  1. Ralph J. Tuthill MD
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Editors and Affiliations

  1. Center for Cancer Drug Discovery and Development, Taussig Cancer Center, The Cleveland Clinic Foundation, Cleveland, OH, USA

    Ernest C. Borden MD (Director) (Director)

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© 2002 Humana Press Inc.,Totowa, NJ

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Tuthill, R.J. (2002). A Pathologist’s Perspective on Prognostic Features of Malignant Melanoma. In: Borden, E.C. (eds) Melanoma. Current Clinical Oncology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-159-6_2

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  • DOI: https://doi.org/10.1007/978-1-59259-159-6_2

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4684-9668-0

  • Online ISBN: 978-1-59259-159-6

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