Prognostic value of tumour vascularity in primary melanoma

To investigate the prognostic value of tumour vascularity we studied 84 pat ients with primary melanomas ranging in tumour thickness (Breslow) from 0.3 7 to 7 mm and in depth of tumour infiltration (Clark) from II to V. Vascula rization was assessed by immunohistochemistry with a CD-31 antibody recogni zing endothelial cells. The CD-31-positive vessels were counted and the deg ree of vascularization was correlated with the survival of the patients, In addition, the relationship between blood vessel density and some histopath ological data is discussed. In our study, the multivariate Cox model showed that the only independent variable in disease-free survival was tumour thi ckness (Breslow classification) and the only one in overall survival was de pth of tumour infiltration (Clark classification). In disease-free survival , tumour thickness (Breslow classification) was a clear prognostic factor ( P=0.004) after 4 years' follow-up, as were depth of tumour infiltration (Cl ark classification) (P=0.04) and ulceration (P=0.04). In overall survival, tumour vascularity was the strongest prognostic factor at 4 years, high vas cularity being associated with a good prognosis (P=0.06). Clark classificat ion was also a prognostic factor(P=0.02) in overall survival. We conclude t hat high vascularization is associated with a better prognosis but is not a n independent prognostic indicator. (C) 1999 Lippincott Williams & Wilkins.