Korean J Dermatol.  2007 Feb;45(2):149-158.

Clinicopathological Features of Cutaneous Malignant Melanoma

Affiliations
  • 1Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea. seokjong@knu.ac.kr
  • 2Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea.

Abstract

BACKGROUND: Malignant melanoma is the leading cause of death among skin cancers in western countries. The incidence of melanoma has been steadily increasing over the last 20 years, and age and sex distribution, anatomic location, clinicopathologic subtypes, and prognostic factors of malignant melanoma are also well known. However, various clinicopathologic aspects such as incidence, clinicopathologic subtypes and tumor behaviors are quite different in Asian and black skin.
OBJECTIVE
The purpose of this study was to investigate the clinicopathologic behavior and statistics of malignant melanoma patients of Kyungpook National University Hospital, and to evaluate prognostic predictors.
METHODS
Of the 97 out of 103 patients diagnosed with malignant melanoma at the Department of Dermatology of Kyungpook National University Hospital over a 14 year period (1992~2006), we analyzed mean age of onset, gender, tumor location, duration, tumor number, color, tumor thickness, Clark's level, pathologic ulceration, tumor- infiltration lymphocytes, clinicopathologic subtype, and clinical AJCC stage. Univariate analysis and multivariate analyses for survival, according to clinical and histologic tumor settings, were performed by means of the Cox proportional hazard model. Survival curves were plotted by the Kaplan-Meier method.
RESULTS
Ninety-seven melanomas were identified and analyzed by both clinical behavior and pathology. Of these, 44 were male and 53 were female patients and the mean age was 59.7 years. Most of the tumors were located on the hands and feet. Thin melanoma was the most common tumor and histologic ulcerations were observed in 37 out of 81 patients who were available for evaluation. For tumor-infiltrating lymphocytes (TIL), 22 out of 76 patients were confirmed with TIL in the pathologic review. Acral lentiginous melanoma was the most common type, followed by nodular melanoma, superficial spreading melanoma, and lentigo maligna melanoma. Univariate analysis for overall survival of melanoma revealed that thickness of tumor, the presence of ulceration, the presence of tumor-infiltrating lymphocytes, clinicopathological subtype, and clinical stage have a tendency for a poorer prognosis. Multivariate analysis demonstrated that advanced stages (III and IV) and tumor thickness were the independent risk factors for poor prognosis.
CONCLUSION
Few similar large studies have been conducted to assess the prognostic factors of melanoma in Korea. Therefore, further prospective studies are needed to assess the biological behavior of malignant melanoma, of which the incidence has been steadily increasing in Korea.

Keyword

Clinical analysis; Cutaneous malignant melanoma; Pathologic analysis

MeSH Terms

Age of Onset
Asian Continental Ancestry Group
Cause of Death
Dermatology
Female
Foot
Gyeongsangbuk-do
Hand
Humans
Hutchinson's Melanotic Freckle
Incidence
Korea
Lymphocytes
Lymphocytes, Tumor-Infiltrating
Male
Melanoma*
Multivariate Analysis
Pathology
Prognosis
Proportional Hazards Models
Risk Factors
Sex Distribution
Skin
Skin Neoplasms
Ulcer
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