Findings suggest some melanoma patients may not experience the same dangers as others.
Melanoma is the worst form of skin cancer, yet it is treatable and has a high survival rate for most people.
There is evidence that an increasing number of cases of melanoma are being overdiagnosed in patients who would never experience signs of the disease.
Using data from cancer registries, researchers have found a group of patients with early-stage melanoma who have seen nearly no melanoma-related deaths.
The research, which is published online by Wiley in CANCER, a peer-reviewed journal of the American Cancer Society, may help doctors figure out which patients have a very low risk of dying from melanoma after the growth is removed.
Researchers Megan M. Eguchi, MPH, Kathleen F. Kerr, PhD, David E. Elder, MB, ChB, FRCPA, and others looked at data from the U.S. Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed in 2010 and 2011 with stage 1 melanoma, defined as a tumor measuring 1.0 mm or less in thickness and having not spread to the lymph nodes.
Models were created to detect melanoma patients with a low and high risk of death in 7 years.
The overall 7-year rate of melanoma death among the 11,594 patients included in the research with follow-up data was 2.5%.
But the models found that 25% of the large group of patients had a risk of less than 1%. Most of these people were younger, and their cancers didn’t spread much into the skin.
A very small subset of patients (less than 1%) who tended to be older and had tumors that were slightly more advanced (but were considered low risk according to current criteria) had a mortality risk of greater than 20%, and these patients can be considered for potentially lifesaving, more complex therapy.
The results demonstrate that a small subset of melanoma patients can be identified by just a few common risk markers, who have a very low probability of dying.
It is hoped that the results of this study can be used as a starting point for future research that uses different study designs and more variables than those in the SEER database to make this classification even better.
“Given the very low risk of death from melanoma associated with some of the cases identified in this study, and if these findings can be verified and perhaps extended in other studies, the use of a different term such as ‘Melanocytic neoplasm of low malignant potential’ may be more appropriate than that of melanoma, as has been done with some other neoplasms or tumors formerly labeled as cancers,” added Dr. Elder. “Such a term may potentially alleviate people’s concerns related to prognosis and outcomes and begin to address the problem of overdiagnosis.”
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