Table 1.
Conventional risk factors of primary early stage cutaneous melanoma
| Risk factor | Evidence summary | References |
|---|---|---|
| Breslow thickness | Consistent evidence supports correlation of BT with recurrence and poor survival; key histologic factor for staging | Gershenwald et al3 |
| Balch et al12 | ||
| Ulceration | Consistent evidence supports correlation of ulceration with recurrence and poor survival; key histologic factor for staging | Gershenwald et al3 |
| Balch et al12 | ||
| Mitotic rate | Consistent evidence supports correlation of MR with recurrence and poor survival; inconsistent evidence for independent value of MR and dichotomization (led to removal as a key histologic factor for staging) | Gershenwald et al3 |
| Balch et al12 | ||
| Lymphovascular invasion | Consistent evidence supports association with SLN positivity and poor survival outcomes; inconsistent evidence to support independent predictive value for outcomes | Namikawa et al15 |
| Egger et al16 | ||
| Positive deep margins | Consistent evidence to support association of PDM with increased risk and consideration of SLNBx for T1a patients | Mills et al18 |
| Koshenkov et al17 | ||
| Tumor infiltrating lymphocytes | Inconsistent evidence associating TILs with good prognosis and negative SLN; several studies have reported no independent prognostic value | Tas et al20 |
| Weiss et al21 | ||
| Clark level | Consistent evidence supports association with recurrence and SLN positivity; lacks independent prognostic value (led to removal as a key histologic factor) | Eriksson et al13 |
| Balch et al12 | ||
| Vertical growth phase | Limited evidence in support of VGP as an independent prognostic feature; VGP is associated with SLN positivity in thin melanomas | Appleton et al22 |
| Eriksson et al13 | ||
| Regression | Inconsistent evidence in support of prognostic value of regression; limited evidence for association with lower SLN positivity rates and better outcomes | Gualano et al23 |
| Ribero et al24 | ||
| Perineural invasion | Weak evidence to support PNI as an independent prognostic factor, other than in the desmoplastic subtype | Namikawa et al15 |
| Frydenlund et al25 |
Abbreviations: SLN, sentinel lymph node; SLNBx, sentinel lymph node biopsy; TIL, tumor infiltrating lymphocyte; VGP, viral protein genome.