Evaluación de factores histológicos pronósticos de sobrevida en melanoma maligno cutáneo, seguimiento de 13 años

Prognostic factors for survival of malignant melanomas Background: The incidence of malignant melanoma is increasing steadily. Aim: To study pathologi- cal prognostic factors in malignant melanomas. Material and Methods: Review of pathological records of cutaneous malignant melanomas diagnosed between 1995 and 2008. Medical records of patients were re- viewed and those with distant metastases at the moment of surgery were excluded. Follow up was performed contacting patients and reviewing death records at the Chilean National Identification Registry. The cause of death was classified as related to the melanoma or unrelated. Results: One hundred sixty two records, corres- ponding to patients aged from 13 to 93 years (51% women), were included in the study. Twenty nine percent of patients died during the follow up period that ranged from 1 to 127 months. Five and ten year's survival was 71 and 60% respectively. A multivariable Cox analysis demonstrated that only the TNM classification of the primary tumor, which is categorized using the Breslow maximal depth, had prognostic significance. Compared to women, men had a 1.97 higher relative risk of dying due to the melanoma. Conclusions: TNM classification of melanomas is the most important prognostic factor for survival.