AUTOMATED MEASUREMENT OF MELANOMA CROSS-SECTIONAL AREA

The object of this study was to evaluate the prognostic impact of a cr oss-sectional area measured in routinely stained slides of cutaneous m elanoma using fully automated image analysis. Hematoxylin-eosin staine d slides of 238 specimens of primary cutaneous melanoma with Clark lev els III to V were evaluated by digital image analysis using color vide o images, a scanning stage, and autofocus equipment. The cross-section al area was significantly related to metastasis-free survival. Lesions with a cross-sectional area less than or equal to 12 mm(2) showed a 2 -year metastasis-free survival rate of 92 +/- 2% compared with 41 +/- 8% in lesions with a cross-sectional area > 12 mm(2) (log rank test: z = 71, p < 0.0001). The same was true for overall survival (98 +/- 1% compared with 82 +/- 6%; z = 42.12, p < 0.0001). In multivariate analy sis, the cross-sectional area seems to provide prognostic information in addition to that provided by Breslow's index. In cases with regress ion and in small melanomas with vertical growth, however, metastatic s pread may occur in lesions with a small cross-sectional area. It was c oncluded that automated measurement-of the cross-sectional area may be helpful in assessing prognosis in cutaneous melanoma.