revised staging system may be necessary

[cohanja]

http://www.healio.com/hematology-oncology/melanoma-skin-cancer/news/online/%7Bbb5a811b-8d08-4cb6-bcaf-b3f05924916d%7D/lymphovascular-invasion-regression-novel-prognostic-factors-in-thin-melanomas

“median time to local recurrence was 79 months, the median time to regional recurrence was 78 months and the median time to distant recurrence was 107 months”

that many months later I would hope I wouldn’t still be worried about it, but I guess it goes to show you still need to pay attention

[TreeFrog]

Interesting article! Thanks for sharing.

Be sure to keep in mind the difference between median and average.

E.g., if you had a set of 10 patients who relapsed, wherein 9 relapsed at 48 months and 1 relapsed at 120 months, the average time until relapse would be 55.2 months but the median time would be 84 months.

Similarly, in the study you cite, the average time to relapse is likely much shorter than the median time.

It will always be the case that the longer one goes without relapse, the better the chances that it will never occur – and from what I understand, most recurrences happen in the first five years.

Best wishes,

~Wendy

[Catherine Poole]

This was a review of data, not an actual study. The data could be flawed as entered. It goes against the most recent study that found regression wasn’t a significant prognostic indicator. I would like to see an equivalent

study, (not just a database review of patients) done in the U.S. I don’t agree the staging system should be revised based on this and they really need to stop using the Clark Level as that is antiquated. When you see these types of news items, be sure to go to the actual study.

[wpatterson4]

They just can’t seem to make up their minds about anything related to regression, including how to measure it and what it says about prognosis. More sources than not (that I’ve seen) claim that extensive regression is indeed a negative prognostic factor.

One thing I’ve read is that thin melanomas with extensive regression tend to metastasize sooner than those without regression and that it equals out over time. Is that true?

[kaya67]

I don’t know if there’s any connection here but is one possible thing that people with previous melanoma may have gotten scans (CT for instance) and the radiation from those types of scans could be the culprit for other cancers later such as thyroid? I have no idea, just asking

[Catherine Poole]

I’m not sure the radiation would be the culprit but perhaps a genetic link. The braf mutation has been found in some of thyroid cancers and so they are using those drugs sometimes for treatment. I agree though, that a lot of scanning can be potentially harmful.

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