Back issues No.3 - 1999 / Original Study  

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Nodular Melanoma-A Thirteen-Year Clinical Experience-
Yi-Ju Chen, Chun-Ying Wu, Jung-Ta Chen, Jui-Lung Shen
Dermatol Sinica 17: 200-207, 1999

From 1985 to 1998, 65 patients were diagnosed as cutaneous malignant melanoma at Taichung Veterans General Hospital. Fifteen of them were nodular melanoma. We reviewed the medical charts of these patients. The pathological specimens were reviewed independently by another physician. We then analyzed the mean age at onset, sex, tumor thickness, level of invasion, primary tumor location and metastatic sites. Univariate analysis for survival, according to clinical and histologic tumor behaviors, was performed by Fisher's exact test. The survival curve was plotted by Kaplan-Meier method. Nodular melanoma was the second common melanoma in this study and comprised about 29% of them. The mean age at onset of nodular melanoma was 56.5 years. The most commonly involved site was the feet, and the most common metastatic sites, in descending order, were lymph node, lungs, brain and bone. The mean involved depth by Breslow's method was 5.92 mm. Most of the lesions were in Clark's level IV and V. Upon diagnosis, nodular melanoma was usually in advanced stage; nearly half of them were in stage IV. Univariate analysis of mortality using Fisher's exact test showed that older age at onset (55 years) and an advanced stage at diagnosis (stage III, IV) predicted a poorer prognosis. Sex, ulceration or pigmentation of tumor, tumor thickness and level of invasion showed no significant differences. The 6-month, 1-year and 3-year survival rates were 75%, 66% and 31.3%, respectively.

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