title: Vascular involvement in the prognosis of primary cutaneous melanoma.
abstract: OBJECTIVE
  To examine the role of vascular invasion as a prognostic factor in melanoma.
  
  
  METHODS
  Retrospective survival analysis.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  A total of 526 patients with primary cutaneous melanoma from the University of California, San Francisco, Melanoma Center database with 2 years of follow-up or documented relapse.
  
  
  METHODS
  (1) Presence of vascular involvement defined as vascular invasion with tumor cells within blood or lymphatic vessels; or uncertain vascular invasion, with melanoma cells immediately adjacent to the endothelium. (2) Percentage with metastasis or death and relapse-free and overall survival.
  
  
  RESULTS
  The presence of either type of vascular involvement significantly increased the risk of relapse and death and reduced the survival associated with melanoma. The impact of vascular involvement on these outcomes was similar to that of ulceration. In a multivariate analysis, vascular involvement was the second most important factor (after tumor thickness) in the primary tumor in predicting survival.
  
  
  CONCLUSIONS
  Vascular involvement is an important independent predictor of metastasis and survival in melanoma. The phenomenon of uncertain vascular invasion describes an earlier step than definite vascular invasion in tumor progression.
authors.affiliation: Melanoma Center, University of California, San Francisco, 1600 Divisadero St, Fourth Floor, San Francisco, CA 94115, USA.
authors.forename: M
authors.initials: M
authors.lastname: Kashani-Sabet
authors.forename: R W
authors.initials: RW
authors.lastname: Sagebiel
authors.forename: C M
authors.initials: CM
authors.lastname: Ferreira
authors.forename: M
authors.initials: M
authors.lastname: Nosrati
authors.forename: J R
authors.initials: JR
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000098:blood supply / Q000401:mortality / Q000473:pathology*; D008833:Microcirculation / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009360:Neoplastic Cells, Circulating; D012306:Risk; D012867:Skin / Q000098:blood supply / Q000473:pathology; D012878:Skin Neoplasms / Q000098:blood supply / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate