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PLoS One. 2015 Mar 26;10(3):e0119716. doi: 10.1371/journal.pone.0119716. eCollection 2015.

Clinicopathologic predictors of survival in patients with desmoplastic melanoma.

Author information

1
Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, United States of America.
2
Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut, United States of America.
3
Department of Biostatistics, Moffitt Cancer Center, Tampa, Florida, United States of America.
4
Department of Radiation Oncology, Florida Hospital, Orlando, Florida, United States of America.
5
Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida, United States of America; Departments of Pathology and Cell Biology and Dermatology, University of South Florida Morsani College of Medicine, Tampa, Florida, United States of America.
6
Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida, United States of America.
7
Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida, United States of America; Departments of Oncologic Sciences and Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, United States of America.

Abstract

BACKGROUND AND OBJECTIVES:

Desmoplastic melanoma is a unique subtype of melanoma which typically affects older patients who often have comorbidities that can adversely affect survival. We sought to identify melanoma-specific factors influencing survival in patients with desmoplastic melanoma.

METHODS:

Retrospective review from 1993 to 2011 identified 316 patients with primary desmoplastic melanoma. Clinicopathologic characteristics were correlated with nodal status and outcome.

RESULTS:

Fifty-five patients (17.4%) had nodal disease: 33 had a positive sentinel lymph node biopsy and 22 developed nodal recurrences (no sentinel lymph node biopsy or false-negative sentinel lymph node biopsy). Nodal disease occurred more often in younger patients and in cases with mixed compared with pure histology (26.7% vs. 14.6%); both of these variables significantly predicted nodal status on multivariable analysis (p<0.05). After a median follow-up of 5.3 years, recurrence developed in 87 patients (27.5%), and 111 deaths occurred. The cause of death was known in 79 cases, with 47 deaths (59.5%) being melanoma-related. On multivariable analysis, Breslow thickness, mitotic rate ≥ 1/mm(2) and nodal status significantly predicted melanoma-specific survival (p<0.05).

CONCLUSIONS:

Nodal status predicts melanoma-specific survival in patients with desmoplastic melanoma. However, since patients with desmoplastic melanoma represent an older population, and a considerable proportion of deaths are not melanoma-related (40.5%), comorbidities should be carefully considered in making staging and treatment decisions in this population.

PMID:
25811671
PMCID:
PMC4374691
DOI:
10.1371/journal.pone.0119716
[Indexed for MEDLINE]
Free PMC Article

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