Prognostic Factors Analysis of 17,600 Melanoma Patients: Validation of the American Joint Committee on Cancer Melanoma Staging System

• DOI: 10.1200/jco.2001.19.16.3622
• Publication Date: 2017-02-24T07:33:42Z
• Authors: Charles M. Balch; Seng-Jaw Soong; Jeffrey E. Gershe...; John F. Thompson; Douglas S. Reintgen; Natale Cascinelli; Marshall Urist; Kelly M. McMasters; Merrick I. Ross; John M. Kirkwood; Michael B. Atkins; John A. Thompson; Daniel G. Coit; David Byrd; Renee Desmond; Yuting Zhang; Ping-Yu Liu; Gary H. Lyman; Aberto Morabito
• Keywords: Occult; Cancer staging; AJCC staging system

PURPOSE: The American Joint Committee on Cancer (AJCC) recently proposed major revisions of the tumor-node-metastases (TNM) categories and stage groupings for cutaneous melanoma. Thirteen cancer centers cooperative groups contributed staging survival data from a total 30,450 melanoma patients their databases in order to validate this proposal. PATIENTS AND METHODS: There were 17,600 with complete clinical, pathologic, follow-up information. Factors predicting melanoma-specific rates analyzed using Cox proportional hazards regression model. Follow-up 5 years or longer available 73% patients. RESULTS: This analysis demonstrated that (1) T category, tumor thickness ulceration most powerful predictors survival, level invasion had significant impact only within subgroup thin (≤ 1 mm) melanomas; (2) N following three independent factors identified: number metastatic nodes, whether nodal metastases clinically occult apparent, presence absence primary ulceration; (3) M nonvisceral was associated better compared visceral metastases. A marked diversity natural history pathologic III by five-fold differences 5-year defined subgroups. also large complex sets could be used effectively examine prognosis outcome CONCLUSION: results evidence-based methodology incorporated into AJCC as described companion publication.