While melanoma remains the most deadly type of skin cancer, new research has found that a subset of patients with early disease are at very low risk of dying.
These particular patients may not face the same prognosis that is typically associated with melanoma, and they may potentially represent cases contributing to over-diagnosis.
The findings were published online Nov. 7 in CANCER, a peer-reviewed journal of the American Cancer Society.
"Given the very low risk of death from melanoma associated with some of the cases identified in this study, and if these findings can be verified and perhaps extended in other studies, the use of a different term such as 'Melanocytic neoplasm of low malignant potential' may be more appropriate than that of melanoma," reasoned researcher Dr. David Elder, a professor of pathology and laboratory medicine at the University of Pennsylvania.
"Such a term may potentially alleviate people's concerns related to prognosis and outcomes, and begin to address the problem of over-diagnosis," Elder said in a journal news release.
In the study, researchers analyzed information from the U.S. Surveillance, Epidemiology, and End Results (SEER) database on patients who were diagnosed in 2010 and 2011 with stage 1 melanoma that was 1.0 mm or less in thickness and had not spread to the lymph nodes.
This included using models to identify patients with a very low risk of dying from melanoma in seven years, as well as those at higher risk of death.
The overall seven-year rate of death from melanoma was 2.5% among the nearly 11,600 patients.
But a subset of 25% of patients had risk below 1%. These patients were typically younger and had minimal invasion of the cancer into their skin.
By comparison, a very small subset of patients, less than 1%, who were older and had slightly more advanced tumors that were still considered low-risk by current criteria, had a greater than 20% risk of death. Those patients could be considered for potentially lifesaving, more complex therapy, the authors said.
The findings may be a starting point for future research using additional variables beyond those available in the SEER database, to further improve this different classification of melanoma, the researchers said.
The U.S. National Cancer Institute has more on melanoma.
SOURCE: CANCER, news release, Nov. 7, 2022