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A scoring system for melanoma may help physicians select which patients should undergo lymphadenectomy and adjuvant chemotherapy or immunotherapy.
The system was outlined at the recent National Clinical Dermatology Conference in Chicago by Darrell Rigel, MD, chief resident in dermatology at New York University School of Medicine.
The single most important prognostic factor appears to be thickness of the lesion, Rigel said, specifically a lesion measuring 4.75 mm or more from the stratum granulosum to the deepest point. Those patients with the thickest lesions died within two years of presentation. Since metastasis occurs early in melanoma, Rigel pointed out, thicker lesions are more likely to have metastasized.
Although 430 factors that potentially affect prognosis of melanoma have been identified, Rigel's group looked only at 40 factors that previously had been shown to be associated with survival. More than 1,100 patients with melanoma were examined, but Rigel reported on only 533,
Cowart VS. Melanoma thickness correlates with prognosis. JAMA. 1982;247(19):2656–2657. doi:10.1001/jama.1982.03320440008004
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