Melanoma Prognosis and Associated Risk Factors: A Retrospective Cohort Study Using Semantic Map Analysis
DOI:
https://doi.org/10.2340/actadv.v103.9591Keywords:
melanoma, outcome, prognosis, risk factors, semantic map analysis, survivalAbstract
The overall patterns of correlations among various melanoma risk factors have not yet been examined. The aim of this study was to assess the impact of different parameters on disease-free and melanoma-related overall survival. A retrospective cohort study was conducted encompassing all patients with a primary cutaneous melanoma diagnosed in a university referral centre. Associations were explored using semantic map analysis, which uses graph theory to find the strongest path of connections between variables. A total of 1,110 melanoma patients (median follow-up 10.6 years) were included. The analysis revealed a clustering of variables around 2 main hubs: Breslow thickness < 1 mm and ≥ 4 mm. Factors connected with high melanoma thickness were: older age, positive sentinel lymph node biopsy findings, presence of ulceration, nodular melanoma type, and light skin phototype. Both disease-free and melanoma-related overall survival were in this cluster and connected with positive sentinel lymph node biopsy and Breslow ≥ 4 mm. Patients with Breslow between 1 and 3.9 mm were also in this cluster and linked with negative sentinel lymph node biopsy, nodular melanoma and safety distance > 10 mm. This semantic analysis confirmed the close link between Breslow thickness, age, sentinel lymph node biopsy findings, skin type, melanoma subtype and prognosis, and provides prognostic information useful for the further stratification and management of patients with melanoma.
Downloads
References
Balch CM, Gershenwald JE. Clinical value of the sentinel-node biopsy in primary cutaneous melanoma. N Engl J Med 2014; 370: 663-664.
https://doi.org/10.1056/NEJMe1313690 DOI: https://doi.org/10.1056/NEJMe1313690
Morton DL, Thompson JF, Cochran AJ, Mozzillo N, Nieweg OE, Roses DF, et al. Final trial report of sentinel-node biopsy versus nodal observation in melanoma. N Engl J Med 2014; 370: 599-609.
https://doi.org/10.1056/NEJMoa1310460 DOI: https://doi.org/10.1056/NEJMoa1310460
Moehrle M, Schippert W, Rassner G, Garbe C, Breuninger H. Micrometastasis of a sentinel lymph node in cutaneous melanoma is a significant prognostic factor for disease-free survival, distant-metastasis-free survival, and overall survival. Dermatol Surg 2004; 30: 1319-1328.
https://doi.org/10.1111/j.1524-4725.2004.30376.x DOI: https://doi.org/10.1111/j.1524-4725.2004.30376.x
Cazzaniga S, Apfelbacher C, Diepgen T, Ofenloch RF, Weisshaar E, Molin S, et al. Patterns of chronic hand eczema: a semantic map analysis of the CARPE registry data. Br J Dermatol 2018; 178: 229-237.
https://doi.org/10.1111/bjd.15660 DOI: https://doi.org/10.1111/bjd.15660
Cazzaniga S, Anzengruber F, Augustin M, Boehncke WH, Borradori L, Conrad C, et al. Linkage between patients' characteristics and prescribed systemic treatments for psoriasis: a semantic connectivity map analysis of the Swiss Dermatology Network for Targeted Therapies registry. J Eur Acad Dermatol Venereol 2019; 33: 2313-2318.
https://doi.org/10.1111/jdv.15983 DOI: https://doi.org/10.1111/jdv.15983
Thomi R, Cazzaniga S, Seyed Jafari SM, Schlapbach C, Hunger RE. Association of hidradenitis suppurativa with t helper 1/t helper 17 phenotypes: a semantic map analysis. JAMA Dermatol 2018; 154: 592-595.
https://doi.org/10.1001/jamadermatol.2018.0141 DOI: https://doi.org/10.1001/jamadermatol.2018.0141
Cazzaniga S, Wiedmer C, Frangež Ž, Shafighi M, Beltraminelli H, Weber B, et al. Association of vascular endothelial growth factor subtypes with melanoma patients' characteristics and survival: a semantic connectivity map analysis. Acta Derm Venereol 2020; 100: adv00019.
https://doi.org/10.2340/00015555-3374 DOI: https://doi.org/10.2340/00015555-3374
Pemmaraju S, Skiena S. Combinatorics and graph theory in mathematica. In: Pemmaraju S, Skiena S, editors. Computational discrete mathematics. Cambridge: Cambridge University Press; 2003, p. 336-337.
https://doi.org/10.1017/CBO9781139164849 DOI: https://doi.org/10.1017/CBO9781139164849
Abbas O, Miller DD, Bhawan J. Cutaneous malignant melanoma: update on diagnostic and prognostic biomarkers. Am J Dermatopathol 2014; 36: 363-379.
https://doi.org/10.1097/DAD.0b013e31828a2ec5 DOI: https://doi.org/10.1097/DAD.0b013e31828a2ec5
Balch CM, Soong SJ, Gershenwald JE, Thompson JF, Reintgen DS, Cascinelli N, et al. Prognostic factors analysis of 17,600 melanoma patients: validation of the American Joint Committee on Cancer melanoma staging system. J Clin Oncol 2001; 19: 3622-3634.
https://doi.org/10.1200/JCO.2001.19.16.3622 DOI: https://doi.org/10.1200/JCO.2001.19.16.3622
Balch CM, Wilkerson JA, Murad TM, Soong SJ, Ingalls AL, Maddox WA. The prognostic significance of ulceration of cutaneous melanoma. Cancer 1980; 45: 3012-3017.
https://doi.org/10.1002/1097-0142(19800615)45:12<3012::AID-CNCR2820451223>3.0.CO;2-O DOI: https://doi.org/10.1002/1097-0142(19800615)45:12<3012::AID-CNCR2820451223>3.0.CO;2-O
Bønnelykke-Behrndtz ML, Schmidt H, Christensen IJ, Damsgaard TE, Møller HJ, Bastholt L, et al. Prognostic stratification of ulcerated melanoma: not only the extent matters. Am J Clin Pathol 2014; 142: 845-856.
https://doi.org/10.1309/AJCPW56PHGLFTKZC DOI: https://doi.org/10.1309/AJCPW56PHGLFTKZC
Seyed Jafari SM, Jäckle P, Michel A, Angermeier S, Hunger R, Shafighi M. Prognostic value of sentinel lymph node biopsy in melanomas of different Breslow's thickness. Swiss Med Wkly 2016; 146: w14358.
https://doi.org/10.4414/smw.2016.14358 DOI: https://doi.org/10.4414/smw.2016.14358
Stoffels I, Boy C, Pöppel T, Kuhn J, Klötgen K, Dissemond J, et al. Association between sentinel lymph node excision with or without preoperative SPECT/CT and metastatic node detection and disease-free survival in melanoma. JAMA 2012; 308: 1007-1014.
https://doi.org/10.1001/2012.jama.11030 DOI: https://doi.org/10.1001/2012.jama.11030
Garbe C, Amaral T, Peris K, Hauschild A, Arenberger P, Bastholt L, et al. European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment - update 2019. Eur J Cancer 2020; 126: 159-177.
https://doi.org/10.1016/j.ejca.2019.11.015 DOI: https://doi.org/10.1016/j.ejca.2019.11.015
Lim Y, Lee J, Lee DY. Is the survival rate for acral melanoma actually worse than other cutaneous melanomas? J Dermatol 2020; 47: 251-256.
https://doi.org/10.1111/1346-8138.15201 DOI: https://doi.org/10.1111/1346-8138.15201
Giblin AV, Thomas JM. Incidence, mortality and survival in cutaneous melanoma. J Plast Reconstr Aesthet Surg 2007; 60: 32-40.
https://doi.org/10.1016/j.bjps.2006.05.008 DOI: https://doi.org/10.1016/j.bjps.2006.05.008
Sim FH, Nelson TE, Pritchard DJ. Malignant melanoma: Mayo Clinic experience. Mayo Clin Proc 1997; 72: 565-569.
https://doi.org/10.4065/72.6.565 DOI: https://doi.org/10.4065/72.6.565
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2023 Simone Cazzaniga, Carole Anouk Zahn, Seyed Morteza Seyed Jafari, Robert Emil Hunger
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work.
Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.