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Seeking `critical difference' in malignant melanoma

Phil Gunby
JAMA. 1981;246(9):927. doi:10.1001/jama.1981.03320090007003.
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Published online


Is malignant melanoma actually a heterogeneous population of cancers? If so, is it possible to identify subtle differences among melanomas that account for survival variability and to treat the patients accordingly?

At Massachusetts General Hospital, Boston, and New York University School of Medicine, members of the Melanoma Clinical Cooperative Group suggest that the answer to both questions is yes. The latest in their series of approaches to determining the prognosis of different melanomas is an analysis of color photographs of the cancers.

So far, the investigators reported at the San Francisco meeting of the Society for Investigative Dermatology, color photographs of 245 stage I primary melanomas have been studied. When the details seen in these photos were added to clinical and histological variables previously analyzed for predictive value in 107 patients with stage I melanoma, a combination of three morphological variables was found to indicate a poor prognosis:



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