Lethal Melanomas

Because nodular melanomas (NMs) often lack the typical features of melanoma (i.e., ABCD rules), they are often detected at a thicker stage than lesions with more typical presentations. Although there has been a trend toward earlier detection of superficial, spreading melanoma (SSM) lesions, the thickness of NMs at diagnosis has remained largely unchanged. To compare rates of death associated with NMs and other tumor subtypes, these investigators analyzed data for 5775 cases of invasive primary cutaneous melanoma reported to the Victorian Cancer Registry in 1989, 1994, 1999, and 2004. They found that the median thickness at diagnosis was 2.6 mm for NMs compared with 0.6 mm for SSMs.

Although only 70f melanomas were thicker than 4 mm, 580f the…