Anatomic site of primary melanoma is associated with depth of invasion

Citation
Y. Hemo et al., Anatomic site of primary melanoma is associated with depth of invasion, ARCH SURG, 134(2), 1999, pp. 148-150
Citations number
23
Categorie Soggetti
Surgery,"Medical Research Diagnosis & Treatment
Journal title
ARCHIVES OF SURGERY
ISSN journal
00040010 → ACNP
Volume
134
Issue
2
Year of publication
1999
Pages
148 - 150
Database
ISI
SICI code
0004-0010(199902)134:2<148:ASOPMI>2.0.ZU;2-2
Abstract
Background: The prognosis of melanoma is correlated to the stage of the pri mary lesion. Tumor site has also been implicated, with locations such as th e trunk carrying a worse prognosis than others (such as limbs). Hypothesis: To determine if tumor thickness correlates with location in a n onvisible body area. Design and Setting: Retrospective medical record review of all patients wit h stage I melanoma treated in our medical center between 1986 and 1994. Dem ographic data as well as primary tumor characteristics were recorded. Methods: The skin's surface was divided into occult and exposed areas. Expo sed indicated visible to the patient during routine activities; occult area s included posterior aspect of the neck, back, posterior aspect of the thig h, calf, and plantar region. Data were analyzed for significance using the chi(2) rest. Results: Of the 178 patients with stage I melanoma analyzed, 51.1% had limb , 35.9% trunk, and 12.9% head and neck lesions. Depth of invasion was less than 0.76 mm in 32.6%, 0.76 to 1.5 mm in 25.2%, and more than 4 mm in 7.9%. In 87 patients the tumor occurred in occult areas and in 91 patients in ex posed areas. Comparing the depth of invasion in these 2 groups disclosed th at thin (<0.76 mm) melanomas occurred in 20.7% of occult areas compared wit h 44% of exposed areas (P<.05). Deeper melanomas (>2.50 mm) occurred in 28. 7% of occult areas compared with 12.1% of exposed areas (P<.05). Conclusions: Tumors in less-visible body areas are significantly thicker at the time of diagnosis than those occurring in more highly visible areas. D elayed detection may be responsible for this finding.