Cutaneous melanoma: patient surveillance and tumor progression.

Abstract

The goal of surveillance examinations (SVE) in patients at high risk for cutaneous melanoma (CM) is to diagnose premetastatic tumors. We attempted to determine whether SVE before CM diagnosis influences the histopathologic features of tumor progression. A retrospective review was conducted of consecutive patients who presented with an intact primary CM during a 36 month period (1991 to 1994) in a university dermatology ambulatory setting. Thirty-nine intact CMs were diagnosed in 34 patients. Compared with 23 CMs in as many patients presenting at the first encounter, 16 CMs diagnosed in 11 patients during SVE had a smaller mean tumor diameter (P = .007) and tumor thickness (P = .002) and were more likely anatomic level I or II (P = .003) with microscopic thickness less than 0.76 mm (P = .01) and less than 0.50 mm (P = .002). Primary CMs are more likely to be smaller and thinner when diagnosed during SVE than at first encounter, features that are likely to have a positive impact on CM mortality.