Objective histopathologic grading of cutaneous malignant melanomas by stereologic estimation of nuclear volume. Prediction of survival and disease-free period

Publisher Website
Google Scholar
Abstract
Modern stereologic techniques enable unbiased and shape-independent estimation of the three-dimensional nuclear volume (v̄v). This study investigates the prognostic impact of v̄v in 47 patients with malignant melanomas (10 years of follow-up) and compares v̄v to traditional prognostic parameters and two-dimensional morphometric estimates. The averaged v̄v was 226 μm3 and 457 μm3 in Stage I and II melanomas, respectively. The v̄v was significantly increased in the case of ulceration, nodular melanoma, and Clark' level gt; III. The v̄v showed only poor correlation to two-dimensional morphometric estimates. Cox regression analysis indicated v̄v to possess excellent prognostic information, only rivaled by tumor ulceration, the latter being a 100% predictor of metastatic spread. Histologic type, Clark' level of invasion, tumor thickness (according to Breslow), and patient sex were without independent prognostic significance, which may be due to attributes of the small data base. It is concluded that v̄v may be a powerful prognostic indicator in cutaneous melanomas, suitable for objective malignancy grading. The clinical and prognostic value of nuclear v̄v needs further investigation in a larger and contemporary series of patients with malignant melanomas.