AlistairJ Cochran

Method of assessing prognosis in patients with malignant melanoma.

Abstract In a retrospective study of 161 patients with malignant melanoma, assessment of the combined influence of a number of features that seem to affect the outcome has been used as the basis of a semiquantitative method of predicting the prognosis. In a prospective study of 54 patients, 45 (84%) fell into either the high-risk or low-risk group, for which the accuracy of prediction was nearly 90%, and the rest had intermediate scores, from which no useful prediction could be made.

Cellular fine structure in the invasive nodules of different histogenetic types of malignant melanoma.

Ultrastructural studies were carried out on the invasive nodule of forty malignant melanomas. The findings support the concept that the fine structure of lentigo maligna melanoma is often characteristic, and differs from that of superficial spreading and nodular melanoma. The melanosomes in lentigo maligna melanoma are usually ellipsoidal and resemble those of normal melanocytes, whereas the melanosomes in superficial spreading and nodular melanoma are most often spheroidal and abnormal in appearance. Superficial spreading and nodular melanomas cannot be distinguished reliably by their ultrastructure.

ASSESSMENT OF PROGNOSIS IN PATIENTS WITH MALIGNANT MELANOMA

Abstract In 85 patients with malignant melanoma the prognosis was assessed by a simple prognostic scoring system based on multiple clinical and pathological features. Prognostication was accurate in rather more than 8 out of 10 patients. This technique, applied successfully by others in the Northern hemisphere, has not proved accurate in Australia, suggesting that where local conditions are different from those in Northern Europe a score-sheet based on local survival statistics may be necessary.

Prediction of Recurrent Melanoma by Variations in the Strength of Anti-Tumor Immunity

The current management of primary malignant melanoma, while by no means totally satisfactory, achieves a reasonable high rate of tumor control, especially in the case of superficial and small volume tumors. The treatment of established metastatic disease is, however, far from satisfactory, most probably because the number of tumor cells involved in clinically detectable metastases is large and such cells tend to be widely dispersed throughout the body, which makes attempts at local control futile. The treatment of choice in this situation, therefore, seems likely to be one which would be active systemically and it is logical that such adjuvant treatment will be most effective against a small volume of tumor.