Bengt Lagerlöf

Resection margins of 2 versus 5 cm for cutaneous malignant melanoma with a tumor thickness of 0.8 to 2.0 mm: A randomized study by the Swedish Melanoma Study Group

The traditional surgical treatment for primary malignant melanoma has often been a wide excision with a margin of about 5 cm. Since the risk of local recurrences is dependent on tumor thickness, thin tumors (<1 mm) have routinely been excised with a narrow margin. For thick tumors, the optimal resection margin is controversial, and can be determined only by prospective, randomized trials.

Prognostic factors in thin cutaneous malignant melanoma

Background. Thin melanomas can metastasize and be lethal. The predictive importance of tumor thickness in thin melanomas and the specific features identifying the patients at risk have not been investigated fully.

Cutaneous malignant melanoma of the head and neck. Analysis of treatment results and prognostic factors in 581 patients: A report from the swedish melanoma study group

Background. Results of surgical treatment of cutaneous malignant melanoma (CMM) have been highly variable, probably because of patient selection. Therefore, a study of representative patients with this disease was performed.

Further evidence for increased light sensitivity in patients with malignant melanoma

Minimal erythema dose (MED), immediate pigment darkening (IPD) and skin typing were performed on 130 patients with malignant melanoma and on seventy‐three controls. The tumours were histologically classified according to Clark as superficial spreading melanoma, nodular melanoma, and lentigo maligna melanoma. The tumours of twelve patients were not possible to classify. Patients belonging to skin type IV and patients with lentigo maligna melanoma had a significantly higher mean age. The IPD reaction was significantly higher in skin type II than in skin types III and IV both in patients and in controls. IPD and MED showed no significant correlation to age and sex. MED was significantly lower among patients with malignant melanoma than controls. These data indicate that light sensitivity is of aetiological importance in malignant melanoma.

The frequency and distribution of mitotic figures in dysplasia and carcinoma in situ

The frequency and topographical (i.e. vertical and lateral) distribution of mitotic figures in normal cervical epithelium as well as in various degrees of dysplasia and in carcinoma in situ, was studied in punch biopsies and in subsequent cone specimens from 40 patients. The frequency of cells in mitosis in the whole thickness of the epithelium increased step‐wise from normal epithelium to slight‐moderate dysplasia, severe dysplasia and carcinoma in situ. A difference in the frequency of mitotic figures between slight and moderate dysplasia was recorded in the superficial cell layers of the epithelium. These findings, together with earlier reported differences in the frequency of DNA synthetizing cells between the various epithelial alterations support the validity of the histological classification of cervical atypias.

Malignant Melanoma of the Skin in Children Registered in the Swedish Cancer Registry During 1959–1971

A clinical follow-up and histopathological reexamination of 26 cases originally diagnosed as malignant melanoma in children under 14 years of age registered in the Swedish Cancer Registry during 1959-1971 has been undertaken. Only one met current criteria of a malignant melanoma. This tumour occurred in a giant naevus in a 3-year-old girl, who died with widespread metastatic melanoma within a year. The other cases were reclassified as melanocytoma of Spitz, cellular blue naevus, compound naevus and neurofibroma. The results confirm that malignant melanoma is a rare tumour in prepubertal children. The risk for histophatological overdiagnosis is much higher in children (95%), than in adults (4%).

Glutathione Transferase P1–1 Expression in Human Melanoma Metastases: Correlation to N-RAS mutations and expression

Expression of the detoxication enzyme glutathione transferase P1-1 (GST P1-1) at elevated levels has been noted in many types of human tumors, including melanomas. The products of the human H-RAS, K-RAS and N-RAS genes play a key role in intracellular signal transduction leading to transcriptional activation of AP-1 (Fos/Jun) responsive genes. The oncogenic mutated forms of the ras proteins are constitutively active and interfere with normal signal transduction. Mutated RAS genes as well as increased expression of wild-type ras proteins are common features in human tumors including melanoma. We have characterized 30 melanoma metastases from 23 melanoma patients with reference to N-RAS expression and mutation as well as to GST P1 expression (immunohistochemistry and genetic analysis). Twenty-three of 30 samples (70%) had high N-Ras p21 and/or N-RAS codon 61 mutations and 18 of these 23 samples also had high GST P1-1 immunoreactivity. Seven of 30 (23%) samples had low N-Ras p21 immunoreactivity and no detectable N-RAS codon 61 mutations. Six of these 7 samples (86%) also had low GST P1-1 immunoreactivity. The results indicate a statistically significant correlation (Spearman correlation coefficient, r = 0.56, p = 0.001, 2-tailed test) and provide, for the first time, indirect evidence for a possible coregulation of N-RAS and GST P1 in human malignant melanoma which should be further evaluated.