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May 1, 2019

The Changing Kinetics of Advanced Melanoma

Author Affiliations
  • 1Memorial Sloan Kettering Cancer Center, New York, New York
JAMA Dermatol. 2019;155(6):657-659. doi:10.1001/jamadermatol.2019.0200

The current issue of JAMA Dermatology contains 3 articles that attempt to describe some aspect of disease kinetics of selected subsets of patients with melanoma.

The first of these studies, from von Schuckmann and colleagues1 in Australia, attempts to describe factors predictive of early recurrence (within 2 years) among patients who presented for treatment of clinically localized T1b to T4b melanoma in Queensland. Patients were recruited prospectively from a number of hospital and private clinic sources. Of 1245 patients identified and invited to participate, 700 (56%) were included in the analysis. Most of the follow-up was obtained as a patient-reported binary recurrence status (yes/no) every 6 months. In the event of patients lost to follow-up, local hospital records and Queensland Cancer Registry data were reviewed. All recurrences were verified insofar as possible by medical record review. Factors identified predicting recurrence within 2 years were not surprising and included the presence of ulceration, an increased mitotic index, increasing T stage, and head and neck location. Descriptive statistics were provided comparing outcomes by the seventh and eighth editions of the AJCC Staging Manual, and describing the initial sites of recurrence.

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