Reporting regression in primary cutaneous melanoma. Part 2: prognosis, evaluation and management

Clin Exp Dermatol. 2020 Oct;45(7):818-823. doi: 10.1111/ced.14329. Epub 2020 Jul 13.

Abstract

The effect of histological regression on patient prognosis for primary cutaneous melanoma is controversial. Some authors hypothesize that regression indicates a robust systemic immune response and may decrease risk of metastasis. Others argue that histological regression calls into question a T0 diagnosis because there may have been an invasive component of the melanoma that is no longer visible but is still active. The literature to date does not suggest that histological regression is associated with increased risk of positive sentinel lymph node status, metastasis or increased risk of mortality. Thus, the presence of histological regression should not change patient staging, evaluation or management. The criteria used for reporting regression have varied dramatically across studies, and standardized reporting is needed to foster evidence-based practices in the future.

Publication types

  • Review

MeSH terms

  • Disease Management
  • Histology / statistics & numerical data
  • Histology / trends
  • Humans
  • Immunity / physiology*
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / pathology
  • Melanoma / diagnosis*
  • Melanoma / epidemiology
  • Melanoma / immunology*
  • Melanoma, Cutaneous Malignant
  • Neoplasm Regression, Spontaneous / pathology
  • Neoplasm Staging / methods
  • Prognosis
  • Sentinel Lymph Node / pathology
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / epidemiology
  • Skin Neoplasms / immunology
  • Skin Neoplasms / pathology*
  • T-Lymphocytes, Regulatory / immunology