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Open AccessJournal ArticleDOI

Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma.

Alexander Breslow
- 01 Nov 1970 - 
- Vol. 172, Iss: 5, pp 902-908
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TLDR
The depth of invasion was studied using the criteria for staging of Clark et al.2 to see if maximal cross-sectional area, thickness, stage of invasion, or a combination of these can be of value in assessing the prognosis of cutaneous melanoma.
Abstract
CuTANEous melanoma is a most unpredictable lesion. The marked variation in prognosis is probably a function of many variables, one of which is the size of the tumor. Though there is a roughly inverse relationship between the diameter of the lesion and survival,5 very small lesions have recurred or metastasized. One possible reason for the lack of reliability of tumor size in estimating prognosis may be that studies to date have considered size in only two diamensions and have neglected tumor volume. Two melanomas can have the same diameter but differ greatly in thickness because of variation in either depth of invasion or degree of protrusion from the surface of the skin or both. A recent study 2 has shown that prognosis correlates well with staging of the depth of invasion, but there have been no studies relating survival to tumor volume. To measure tumor volume it is necessary to know the surface area of the tumor, but in this retrospective study we only know the maximal diameters of the lesions. By measuring the maximal thickness of the lesions we can calculate the maximal crosssectional area, which should be roughly proportional to the volume of the tumor. The depth of invasion was also studied using the criteria for staging of Clark et al.2 to see if maximal cross-sectional area, thickness, stage of invasion, or a combination of these can be of value in assessing the prognosis of cutaneous melanoma. A total of 98 lesions were so studied.

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Citations
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Polypoid melanoma: a virulent variant of nodular melanoma. Report of three cases and literature review.

TL;DR: Although polypoid melanoma is considered the most malignant form of melanoma, the findings suggest that early diagnosis and prompt surgical excision may provide a favorable 5-year survival rate.
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High levels of MMP-1 expression in the absence of the 2G single nucleotide polymorphism is mediated by p38 and ERK1/2 mitogen-activated protein kinases in VMM5 melanoma cells.

TL;DR: The data suggest that tumor cells may use alternative signal/transduction pathways and cis‐acting sequences to achieve high levels of MMP‐1 expression, which contribute to the ability of tumor cells to invade, regardless of their genotype.
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Mitotic rate and S-phase fraction as prognostic factors in stage I cutaneous malignant melanoma.

TL;DR: The present results indicate that mitotic activity index (MAI), volume-corrected mitotic index (M/V index) and S-phase fraction (SPF) are important prognostic factors in addition to the well-established Breslow thickness in stage I cutaneous malignant melanoma.
Journal ArticleDOI

Clinical correlates of Breslow thickness of malignant melanoma.

TL;DR: Breslow thickness is a major predictor of prognosis in cutaneous malignant melanoma (MM) and patients continue to present with thick lesions, which have a poorer prognosis.
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High plasma level of a eumelanin precursor, 6-hydroxy-5-methoxyindole-2-carboxylic acid as a prognostic marker for malignant melanoma

TL;DR: The measurement of plasma levels of melanin metabolites provides a method for detecting occult melanoma metastasis and estimating the prognosis of melanoma patients, plasma 6H5MI2C level being more sensitive and reliable than that of 5-S-CD, and its increased level being a high risk factor.
References
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Journal ArticleDOI

Some Methods for Strengthening the Common χ 2 Tests

TL;DR: In this article, the authors discuss two kinds of failure to make the best use of x2 tests which I have observed from time to time in reading reports of biological research, and propose a number of methods for strengthening or supplementing the most common uses of the ordinary x2 test.
Journal Article

The Histogenesis and Biologic Behavior of Primary Human Malignant Melanomas of the Skin

TL;DR: Evidence is presented suggesting that superficial spreading melanoma and lentigo maligna melanoma (Hutchinson9s melanotic freckle) show a long period of superficial growth, followed by the relatively rapid appearance of nodules or deeper invasion within the primary lesion.
Journal ArticleDOI

The Detection of Partial Association, I: The 2 × 2 Case

TL;DR: In this article, a criterion for testing null hypotheses of conditional independence of two dichotomous random variables is derived for testing whether the association of the two random variables in the conditional distribution is, in a certain sense, constant.
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