Comparative performance of predictors of death from thin (≤1.0 mm) melanoma

What is known?

Despite overall favourable prognosis, thin (≤1.0 mm) cutaneous melanoma account for 23% of melanoma deaths in Queensland because of the sheer volume of disease.

The availability of adjuvant systemic therapy has increased the focus on identifying patients with thin melanoma who are at high risk of death, for example using gene expression profiling (GEP), sentinel lymph node biopsy (SLNB), or prognostic models.

What is new?

Study cohort included people diagnosed with a thin melanoma in Queensland who had either died from their thin melanoma within five years (n=228) or survived at least five years post-diagnosis (n=17,148).

The model prognostic model including scalp location and 0.8-1.0mm thickness correctly identified 118 of 228 deaths within five years of diagnosis (sensitivity 52%) and correctly classified 14,740 of the 17,148 survivors among the whole cohort (specificity 86%). Positive predictive value was 5% and negative predictive value was 99%.

What does this mean?

Two readily available clinicopathologic factors, namely scalp location and 0.8-1.0 mm thickness, identify a group of patients at higher than average risk of death with a sensitivity that exceeds SLNB and 31-GEP testing.

Contact: Peter Baade

Reference: Claeson M, Baade P, Marchetti M, Brown S, Soyer HP, Smithers BM, Green AC, Whiteman DC, Khosrotehrani K. Comparative performance of predictors of death from thin (</=1.0 mm) melanoma. British Journal of Dermatology. 2021. doi: 10.1111/bjd.20480.

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