Site Editor
Soo Park, MD
Soo Park, MD
Posted: Wednesday, February 5, 2025
For patients with primary cutaneous melanoma, the Breslow thickness may be a significant prognostic tool that can be used to guide patient management, according to an Australian study published in JAMA Dermatology. Primary tumors with a Breslow thickness between 0.8 to 1.0 mm were associated with a significantly increased risk of melanoma-related death; therefore, these patients may require additional therapeutic strategies, explained John F. Thompson, MD, of the Melanoma Institute Australia, Sydney, and colleagues.
“To our knowledge, this is the largest analysis to date of the association of Breslow thickness with the risk of melanoma-related death in patients with thin melanomas and the first to use methods that take into account the competing risk of death from other causes,” the investigators noted. “These results suggest that a change of the T1 threshold from 1.0 mm to 0.8 mm should be considered when the AJCC staging system is next reviewed.”
A total of 144,447 patients whose first thin invasive primary melanoma occurred between 1982 and 2014 were recruited for the study. Patient data were obtained from the Australian state and territory population-based cancer registries and the Australian National Death Index. All patients were stratified based on the Breslow thickness of their tumors: those less than 0.8 mm and those between 0.8 and 1.0 mm.
The study authors reported a 6.3% overall crude incidence rate of melanoma-related death 20 years after diagnosis. When the findings were stratified by tumor thickness, the rate was 6% and 12% for patients with tumors less than 0.8 mm and those with tumors between 0.8 mm and 1.0 mm, respectively. Furthermore, there was an increased absolute risk of melanoma-related death (subdistribution hazard ratio [HR] = 2.92) and rate of melanoma-related death (HR = 2.98) in patients with tumors between 0.8 mm to 1.0 mm compared with patients who had tumors less than 0.8 mm. Moreover, no significant association was identified between Breslow thickness and nonmelanoma-related causes of death.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
JNCCN Spotlights
