Year: 2005
Type: letter
Abstract: We are sending this letter almost 4 years after publication of the article, because we have become aware of a curious feature of the data that escaped our attention previously.The article analyzed the clinical outcomes of 17,600 melanoma patients in a database compiled from 13 cancer centers and cooperative groups around the world.The results of the analysis formed the basis of a new melanoma staging system that was adopted universally.What is unusual about the article is the method used for calculating the overall survival times of the patients with stage III melanoma.Whereas virtually all previously published studies used as the starting point the date of documentation of lymph node metastasis (usually the date of lymphadenectomy), Balch et al chose the date of diagnosis of the primary melanoma.The use of an earlier starting point may have affected the authors' conclusions, upon which the new staging system was based.The most important of those conclusions was the association of ulceration of the primary lesion with decreased overall survival in patients with stage III disease.At the time of the article's appearance, this was a striking and unexpected observation.However, it may be explained by the unorthodox method of survival analysis, because ulcerated primaries simply may have resulted in the more rapid development of nodal metastases.One wonders whether the prognostic importance
Source: Journal of Clinical Oncology
Institution: Thomas Jefferson University
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2076141543