Predicting Prognosis with Thin Melanoma
“Most patients do well at 5 years; 95% are doing fine,” Dr. Christopher J. Miller said at a summer symposium of the Alabama Dermatology Society.
This figure comes from a study (Arch. Dermatol. 2002:138:603-8) that found 95.3% of patients survive at least 5 years if they have thin (< 1 mm) melanoma, stage II/III disease, with no ulceration.
“About 10% are not doing as well,” Dr. Miller said, referring to a different group with thin melanoma (< 1 mm, stage IV/V with ulceration). In this group, study researchers found a 5-year survival rate of 90.9%.
So how do you estimate prognosis for your individual patient? Dr. Miller recommended www.melanomaprognosis.org, a fast and easy-to-use (I tried it!) instrument to estimate survival based on a few characteristics.
“This is a great tool … and a useful thing to have for your patients,” said Dr. Miller, director of dermatologic surgery at the University of Pennsylvania in Philadelphia. Using a number of factors to calculate survival is more accurate than relying on just one measure or using survival curves, he said.
I tried the site Dr. Miller recommended for a hypothetical patient with localized melanoma. I found that a 45-year-old with a 1-mm ulcerated lesion located on an axial site would have an estimate survival rate of:
98.8% at 1 year
96.8% at 2 years
86.5% at 5 years
73% at 10 years.
The online calculator was developed using the melanoma database of the American Joint Committee on Cancer.
–Damian McNamara @MedReporter on Twitter