دورية أكاديمية

Changes in the presentation of nodular and superficial spreading melanomas over 35 years.

التفاصيل البيبلوغرافية
العنوان: Changes in the presentation of nodular and superficial spreading melanomas over 35 years.
المؤلفون: Warycha, Melanie A., Christos, Paul J., Mazumdar, Madhu, Darvishian, Farbod, Shapiro, Richard L., Berman, Russell S., Pavlick, Anna C., Kopf, Alfred W., Polsky, David, Osman, Iman
المصدر: Cancer (0008543X); 12/15/2008, Vol. 113 Issue 12, p3341-3348, 8p, 2 Charts
مصطلحات موضوعية: MELANOMA, PRECANCEROUS conditions, NEUROENDOCRINE tumors, ULCERS, TUMORS, MELANOMA diagnosis, CANCER invasiveness, COMPARATIVE studies, RESEARCH methodology, MEDICAL cooperation, RESEARCH, RESEARCH funding, SKIN tumors, TIME, EVALUATION research, EARLY detection of cancer, DIAGNOSIS
مستخلص: Background: Nodular melanoma (NM) may be biologically aggressive compared with the more common superficial spreading melanoma (SSM), with recent data suggesting underlying genetic differences between these 2 subtypes. To better define the clinical behavior of NMs, the authors compared their clinical and histopathologic features to those of SSMs at their institution, a tertiary referral center, over 3 decades.Methods: A total of 1,684 patients diagnosed with 1,734 melanomas were prospectively enrolled. Of these, 1,143 patients (69% SSM, 11% NM, 20% other) were diagnosed between 1972 and 1982; 541 patients (54% SSM, 23% NM, 23% other) were diagnosed between 2002 and the present. Differences between the features of NM and SSM within each time period as well as changes over time were analyzed.Results: The authors found that SSMs are now diagnosed as thinner lesions (P < .0001) with a low incidence of histologic ulceration (P < .0001), whereas there was no significant change in the median tumor thickness or ulceration status of NMs over time (P = .10, P = .30, respectively). The median age at diagnosis of NM, however, did significantly increase over time (51 years to 63 years, P < .01). The median duration of NMs was reported to be only 5 months compared with 9 months in SSM patients.Conclusions: The authors' data suggest that improvements have been made in the early detection of SSM but not NM. Modifications of current screening practices, including increased surveillance of high-risk patients with an emphasis on the "E" for "evolution" criterion of the ABCDE acronym used for early detection of melanoma, are thus warranted. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:0008543X
DOI:10.1002/cncr.23955