The kinetics of the visible growth of a primary melanoma reflects the tumor aggressiveness and is an independent prognostic marker: A prospective study

✍ Scribed by Jean Jacques Grob; Marie Aleth Richard; Johany Gouvernet; Marie Françoise Avril; Michèle Delaunay; Pierre Wolkenstein; Pierre Souteyrand; Jean Jacques Bonerandi; Laurent Machet; Jean Claude Guillaume; Jacqueline Chevrant-Breton; Catherine Vilmer; François Aubin; Bernard Guillot; Marie Beylot-Barry; Catherine Lok; Nadia Raison-Peyron; Philippe Chemaly; Groupe de Cancérologie Cutanée; Société Francaise de Dermatologie; France

• Publisher: John Wiley and Sons
• Year: 2002
• Tongue: French
• Weight: 90 KB
• Volume: 102
• Category: Article
• ISSN: 0020-7136
• DOI: 10.1002/ijc.10660

✦ Synopsis

Abstract

Primary melanoma (MM) could be a good model to test an intuitive concept: a cancer that is growing fast in its early phase is likely to have a high aggressiveness. Since MMs are visible tumors, many patients can provide information to indirectly assess the kinetics of their lesion. A prospective study was designed to assess if the kinetics of the visible growth of a primary MM, as described by the patient, could be a noninvasive prognostic marker. The ratio of MM thickness to delay between MM appearance and MM removal was used as a surrogate value for the kinetics of the MM growth. To assess the delay between MM appearance and removal, 362 patients with self‐detected invasive MM fulfilled a detailed questionnaire, which provided 2 types of estimations of this delay and thus 2 melanoma kinetics indexes (MKI and MKI*). After a median follow‐up of 4 years, univariate and multivariate analyses assessed whether relapse‐free survival was linked to MKI or MKI*. MKI was significantly predictive of relapse‐free survival (HR = 1.84 [1.51–2.25]) and relapse at 1 year (RR = 2.93 [1.84–4.69]), independently from Breslow thickness. MKI was retained in multivariate prognostic models, just after thickness and before other usual markers. MKI* was also a significant independent risk marker, although less predictive. In this model, the initial growth kinetics of a cancer reflects its aggressiveness and a high index predicts a short‐term relapse. The “subjective” data obtained from patients about their MM history, although usually neglected, can thus provide a better prognostic marker than many “objective” tests. © 2002 Wiley‐Liss, Inc.