Abstract
BackgroundA high percentage of patients with thin melanoma (TM), defined as lesions with Breslow thickness ≤1 mm, presents excellent long-term survival, however, some patients develop metastases. Existing prognostic factors cannot reliably differentiate TM patients at risk for metastases.ObjectiveWe aimed at characterizing the clinical-pathologic and mutation profile of metastatic and not-metastatic TM in order to distinguish lesions at risk of metastases.MethodsClinical-pathologic characteristics were recorded for the TM cases analyzed. We used a Next Generation Sequencing (NGS) multi-gene panel to characterize TM for multiple somatic mutations.ResultsA statistically significant association emerged between the presence of metastases and Breslow thickness ≥0.6 mm (p=0.003). None of TM with lymph-node involvement had Breslow thickness <0.6 mm. Somatic mutations were identified in 19 of 21 TM analyzed (90.5%). No mutations were observed in two not-metastatic cases with the lowest Breslow thickness (≤0.4 mm), whereas mutations in more than one gene were detected in one metastatic case with the highest Breslow thickness (1.00 mm).ConclusionOur study indicates Breslow thickness ≥0.6 mm as a valid prognostic factor to distinguish TM at risk for metastases.
Highlights
From a clinical and molecular standpoint, melanoma is a complex, heterogeneous and unpredictable disease
Clinical-pathologic characteristics were recorded for the thin melanoma (TM) cases analyzed
A statistically significant association emerged between the presence of metastases and Breslow thickness ≥0.6 mm (p=0.003)
Summary
From a clinical and molecular standpoint, melanoma is a complex, heterogeneous and unpredictable disease. The incidence of malignant melanoma (MM) has drastically increased in the past decades [1]. 70% of new cases of MM are thin melanomas (TM), which are lesions ≤1.00 mm in Breslow thickness, and TM diagnosis are increasing around the world [2]. Thin tumors have a 10-year survival rate of 85-90% [3]. The high percentage of TM without recurrences is in contrast with a group that could develop recurrences and regional or distant metastases [4,5,6,7]. A high percentage of patients with thin melanoma (TM), defined as lesions with Breslow thickness ≤1 mm, presents excellent long-term survival, some patients develop metastases. Existing prognostic factors cannot reliably differentiate TM patients at risk for metastases
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