Using a continuous transformation of the Breslow thickness for prognosis in cutaneous melanoma.

Published

Journal Article

Although the Breslow thickness provides the most important histologic information for prognosis in cutaneous melanoma, controversies and uncertainty remain about how best to use thickness. It is unclear whether cut points should be used, or, if they are used, which are optimal. We studied new data collected from more than 1,000 patients followed up for a relatively long period. From Cox proportional hazards models of survival we learned that more cut points provide more prognostic information than using, for example, just 1 cut point at 1.7 mm. Nevertheless, a continuous transformation provides an effective alternative that captures the information that thickness provides, and it avoids the pitfalls of using multiple cut points. In a multivariate model, this transformation provided strong prognostic information, and the result produced a prognostic score for cutaneous melanoma. This score provides a practical way that Cox model results can be used, and we believe it consolidates the prognostic information provided by traditional histologic and clinical variables. When newer prognostic variables are introduced, we suggest that they be used with this continuous transformation of thickness rather than with cut points in thickness.

Full Text

Duke Authors

Cited Authors

  • Vollmer, RT; Seigler, HF

Published Date

  • February 2001

Published In

Volume / Issue

  • 115 / 2

Start / End Page

  • 205 - 212

PubMed ID

  • 11211608

Pubmed Central ID

  • 11211608

International Standard Serial Number (ISSN)

  • 0002-9173

Digital Object Identifier (DOI)

  • 10.1309/WAVR-560R-NU5E-4Q96

Language

  • eng

Conference Location

  • England