Melanoma Coverage from Every Angle
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New Prognostic Tool for Cutaneous Malignant Melanoma

By: Celeste L. Dixon
Posted: Tuesday, August 13, 2019

When it comes to tumor measurement, are two dimensions better than one? Could well be, according to the results of a retrospective study of 1,239 patients with invasive cutaneous melanoma. Calculated tumor area (CTA) is described as “a novel, simple microscopic feature and a two-dimensional surrogate for tumor size,” by Gerald Saldanha, FRCPath, of Leicester Cancer Research Centre, University of Leicester, United Kingdom, and colleagues. “Tumor size is important because it estimates invasive cancer cell burden.”

In their proof-of-concept work, published in JAMA Dermatology, stratifying melanoma into groups based on CTA had better prognostic value for survival than T category, which is based on Breslow thickness, the current one-dimensional standard measurement. CTA was an independent prognostic factor after adjusting for Breslow thickness, age, sex, ulcer, mitotic rate, and microsatellites (hazard ratio = 1.70; P  < .001). Of the 1,239 patients, 649 (52.4%) were women, with a median age of 60 years.

“Melanomas stratified by CTA showed wider separation of survival curves than those stratified by Breslow thickness using the American Joint Committee on Cancer Staging Manual, 8th Edition. [Also], the model with CTA categories had a Bayesian information criterion difference of 13.9 compared with T category, indicating [a] substantially better fit,” explained Dr. Saldanha and his team. As such, they emphasized, CTA “should be prioritized for investigation to verify its prognostic value and to assess its applicability and acceptability in routine practice.”

Disclosure: The study authors’ disclosure information may be found at jamanetwork.com.



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