Prognostic significance of tumor size for primary invasive cutaneous melanoma: A population‐based study, 2004‐2016
Abstract Background This study aimed to assess the independent prognostic value of tumor size compared with other clinical and pathologic features of primary invasive cutaneous melanoma (CM). Methods This study included 28,593 patients with primary invasive CM in Surveillance, Epidemiology, and End...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-07-01
|
| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.3065 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850248417720139776 |
|---|---|
| author | Qiuying Ma Huinan Suo Li Zhu Yue Qian Xiaoyan Sun Jun Xie Qianru Li Yangxue Fu Jun Li Juan Tao |
| author_facet | Qiuying Ma Huinan Suo Li Zhu Yue Qian Xiaoyan Sun Jun Xie Qianru Li Yangxue Fu Jun Li Juan Tao |
| author_sort | Qiuying Ma |
| collection | DOAJ |
| description | Abstract Background This study aimed to assess the independent prognostic value of tumor size compared with other clinical and pathologic features of primary invasive cutaneous melanoma (CM). Methods This study included 28,593 patients with primary invasive CM in Surveillance, Epidemiology, and End Results Program database diagnosed from 2004 through 2016. Tumor size was divided into five subgroups (≤6, 7‐12, 13‐30, 31‐42, and >42 mm). The primary endpoint was melanoma‐specific survival (MSS). Results The relationship between tumor size and survival was piecewise. After adjusting for age, sex, primary site, histopathologic cell type, Breslow thickness, ulceration, mitotic rate, regional metastasis, and distant metastasis, the hazard ratio (HR) of MSS increased with increasing tumor size until a peak at 31‐42 mm (HRs, 1.33, 1.59, 2.41, respectively; all P < .0001), and then decreased when tumor size was larger than 42 mm using tumor size ≤ 6 mm as the reference (HR, 2.11; 95% confidence interval [CI], 1.84 −2.42; P < .0001). This pattern mostly remained after stratification by T subcategories from T1 to T4 in localized primary CM except that tumor size >42 mm subgroup had the shortest MSS in T4. In addition, tumor size with a cutoff value of 12 mm showed stronger prognostic value for MSS (HR, 2.32; 95% CI, 1.80‐2.98; P < .0001) than Breslow thickness and mitotic rate in primary CM with T1N0M0. Conclusions Tumor size was an important independent prognostic factor for MSS in patients with primary invasive CM. Tumor size larger than 30 mm would provide additional and important prognostic information in each T subcategory of localized CM. Furthermore, tumor size with a cutoff value of 12 mm has great potential in improving the accuracy of melanoma T1 substaging. |
| format | Article |
| id | doaj-art-924882ac9e774599b3dc14a757a3db3d |
| institution | OA Journals |
| issn | 2045-7634 |
| language | English |
| publishDate | 2020-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-924882ac9e774599b3dc14a757a3db3d2025-08-20T01:58:43ZengWileyCancer Medicine2045-76342020-07-019134561457110.1002/cam4.3065Prognostic significance of tumor size for primary invasive cutaneous melanoma: A population‐based study, 2004‐2016Qiuying Ma0Huinan Suo1Li Zhu2Yue Qian3Xiaoyan Sun4Jun Xie5Qianru Li6Yangxue Fu7Jun Li8Juan Tao9Department of Dermatology Union Hospital Tongji Medical College Huazhong University of Science and Technology (HUST) Wuhan ChinaDepartment of Dermatology Union Hospital Tongji Medical College Huazhong University of Science and Technology (HUST) Wuhan ChinaDepartment of Dermatology Union Hospital Tongji Medical College Huazhong University of Science and Technology (HUST) Wuhan ChinaDepartment of Dermatology Union Hospital Tongji Medical College Huazhong University of Science and Technology (HUST) Wuhan ChinaDepartment of Dermatology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology (HUST) Wuhan ChinaDepartment of Dermatology Zhongnan Hospital Wuhan University Wuhan ChinaDepartment of Dermatology Union Hospital Tongji Medical College Huazhong University of Science and Technology (HUST) Wuhan ChinaDepartment of Dermatology Union Hospital Tongji Medical College Huazhong University of Science and Technology (HUST) Wuhan ChinaDepartment of Dermatology The Central Hospital of Wuhan Tongji Medical College Huazhong University of Science and Technology (HUST) Wuhan ChinaDepartment of Dermatology Union Hospital Tongji Medical College Huazhong University of Science and Technology (HUST) Wuhan ChinaAbstract Background This study aimed to assess the independent prognostic value of tumor size compared with other clinical and pathologic features of primary invasive cutaneous melanoma (CM). Methods This study included 28,593 patients with primary invasive CM in Surveillance, Epidemiology, and End Results Program database diagnosed from 2004 through 2016. Tumor size was divided into five subgroups (≤6, 7‐12, 13‐30, 31‐42, and >42 mm). The primary endpoint was melanoma‐specific survival (MSS). Results The relationship between tumor size and survival was piecewise. After adjusting for age, sex, primary site, histopathologic cell type, Breslow thickness, ulceration, mitotic rate, regional metastasis, and distant metastasis, the hazard ratio (HR) of MSS increased with increasing tumor size until a peak at 31‐42 mm (HRs, 1.33, 1.59, 2.41, respectively; all P < .0001), and then decreased when tumor size was larger than 42 mm using tumor size ≤ 6 mm as the reference (HR, 2.11; 95% confidence interval [CI], 1.84 −2.42; P < .0001). This pattern mostly remained after stratification by T subcategories from T1 to T4 in localized primary CM except that tumor size >42 mm subgroup had the shortest MSS in T4. In addition, tumor size with a cutoff value of 12 mm showed stronger prognostic value for MSS (HR, 2.32; 95% CI, 1.80‐2.98; P < .0001) than Breslow thickness and mitotic rate in primary CM with T1N0M0. Conclusions Tumor size was an important independent prognostic factor for MSS in patients with primary invasive CM. Tumor size larger than 30 mm would provide additional and important prognostic information in each T subcategory of localized CM. Furthermore, tumor size with a cutoff value of 12 mm has great potential in improving the accuracy of melanoma T1 substaging.https://doi.org/10.1002/cam4.3065cutaneous melanomamelanoma‐specific survivalstagingSEERtumor size |
| spellingShingle | Qiuying Ma Huinan Suo Li Zhu Yue Qian Xiaoyan Sun Jun Xie Qianru Li Yangxue Fu Jun Li Juan Tao Prognostic significance of tumor size for primary invasive cutaneous melanoma: A population‐based study, 2004‐2016 Cancer Medicine cutaneous melanoma melanoma‐specific survival staging SEER tumor size |
| title | Prognostic significance of tumor size for primary invasive cutaneous melanoma: A population‐based study, 2004‐2016 |
| title_full | Prognostic significance of tumor size for primary invasive cutaneous melanoma: A population‐based study, 2004‐2016 |
| title_fullStr | Prognostic significance of tumor size for primary invasive cutaneous melanoma: A population‐based study, 2004‐2016 |
| title_full_unstemmed | Prognostic significance of tumor size for primary invasive cutaneous melanoma: A population‐based study, 2004‐2016 |
| title_short | Prognostic significance of tumor size for primary invasive cutaneous melanoma: A population‐based study, 2004‐2016 |
| title_sort | prognostic significance of tumor size for primary invasive cutaneous melanoma a population based study 2004 2016 |
| topic | cutaneous melanoma melanoma‐specific survival staging SEER tumor size |
| url | https://doi.org/10.1002/cam4.3065 |
| work_keys_str_mv | AT qiuyingma prognosticsignificanceoftumorsizeforprimaryinvasivecutaneousmelanomaapopulationbasedstudy20042016 AT huinansuo prognosticsignificanceoftumorsizeforprimaryinvasivecutaneousmelanomaapopulationbasedstudy20042016 AT lizhu prognosticsignificanceoftumorsizeforprimaryinvasivecutaneousmelanomaapopulationbasedstudy20042016 AT yueqian prognosticsignificanceoftumorsizeforprimaryinvasivecutaneousmelanomaapopulationbasedstudy20042016 AT xiaoyansun prognosticsignificanceoftumorsizeforprimaryinvasivecutaneousmelanomaapopulationbasedstudy20042016 AT junxie prognosticsignificanceoftumorsizeforprimaryinvasivecutaneousmelanomaapopulationbasedstudy20042016 AT qianruli prognosticsignificanceoftumorsizeforprimaryinvasivecutaneousmelanomaapopulationbasedstudy20042016 AT yangxuefu prognosticsignificanceoftumorsizeforprimaryinvasivecutaneousmelanomaapopulationbasedstudy20042016 AT junli prognosticsignificanceoftumorsizeforprimaryinvasivecutaneousmelanomaapopulationbasedstudy20042016 AT juantao prognosticsignificanceoftumorsizeforprimaryinvasivecutaneousmelanomaapopulationbasedstudy20042016 |