Prognostication in thin cutaneous melanomas.
BACKGROUND
While most patients diagnosed with thin cutaneous melanoma will have a good prognosis, nearly 5% will die of their disease. Thin melanomas are common and approximately one-quarter of all melanoma-related deaths result from thin primary tumors. Patients with thin melanoma commonly have sentinel lymph node biopsies that are uncommonly positive.


OBJECTIVE
To review the progress that has been made in the translation of prognostic and predictive biomarkers for patients with thin melanomas by focusing on the developments during the last 5 years in using measures of tumor proliferation. Given the paucity of biomarkers for patients with thin melanoma, we review some of the challenges in the development, validation, and translation of new biomarkers into clinical practice.


METHODS
Surveillance, Epidemiology and End Results registry data, cohort data from a cancer center's program in melanoma, and focused literature review.


CONCLUSIONS
The presence of dermal mitoses improves prognostication and prediction. To optimize patient management, biomarkers reflecting biologic processes underlying tumor progression will need to be included in panels and risk models, validated, generalized, and ratified.
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, 19104-6021, USA. pgimotty@upenn.edu
Phyllis A
PA
Gimotty
DuPont
D
Guerry
D014408:Biomarkers, Tumor / Q000378:metabolism; D049109:Cell Proliferation; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000145:classification / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality; D009367:Neoplasm Staging; D011379:Prognosis; D018426:SEER Program; D012878:Skin Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality; D015996:Survival Rate
D014408:Biomarkers, Tumor