Información del artículo
Abstract
Skin histopathology reports of melanoma routinely include important prognostic information used in the staging system of the American Joint Committee on Cancer (AJCC). This information, which influences disease management, includes tumor depth, presence of ulceration, number of mitotic figures, and presence or absence of microsatellites. However, numerous studies have found many other factors that are not included in the AJCC classification but that are nevertheless of prognostic significance. We discuss these factors in this paper
Keywords:
Melanoma
Prognosis
Histology
Resumen
En un informe rutinario dermatopatológico sobre un melanoma se recoge una significativa información pronóstica para el manejo de estos pacientes y que actualmente es empleada en la estadificación de la American Joint Committee on Cancer como el grosor tumoral, la presencia de ulceración, el número de mitosis y la presencia o no de microsatelitosis. Sin embargo, existen múltiples factores que si bien no están incluidos en esta clasificación, han demostrado tener un impacto pronóstico en diversos estudios y que son objeto del presente texto.
Palabras clave:
Melanoma
Pronóstico
Histología
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References
[1.]
C.M. Balch, J.E. Gershenwald, S.J. Soong, J.F. Thompson, M.B. Atkins, D.R. Byrd, et al.
Final version of 2009 AJCC melanoma staging and classification.
J Clin Oncol, 27 (2009), pp. 6199-6206
[2.]
R.M. MacKie, C. Bray, J. Vestey, V. Doherty, A. Evans, D. Thomson, et al.
Melanoma incidence and mortality in Scotland 1979–2003.
Br J Cancer, 96 (2007), pp. 1772-1777
[3.]
K.G. Lasithiotakis, U. Leiter, R. Gorkievicz, T. Eigentler, H. Breuninger, G. Metzler, et al.
The incidence and mortality of cutaneous melanoma in Southern Germany: trends by anatomic site and pathologic characteristics, 1976 to 2003.
Cancer, 107 (2006), pp. 1331-1339
[4.]
R.M. MacKie, D. Hole, J.A. Hunter, R. Rankin, A. Evans, K. McLaren, et al.
Cutaneous malignant melanoma in Scotland: incidence, survival, and mortality, 1979–94. The Scottish Melanoma Group.
BMJ, 315 (1997), pp. 1117-1121
[5.]
C. Lindholm, R. Andersson, M. Dufmats, J. Hansson, C. Ingvar, T. Möller, et al.
Invasive cutaneous malignant melanoma in Sweden, 1990–1999. A prospective, population-based study of survival and prognostic factors.
Cancer, 101 (2004), pp. 2067-2078
[6.]
F. Levi, L. Randimbison, C. La Vecchia, V.C. Te, S. Franceschi.
Prognostic factors for cutaneous malignant melanoma in Vaud, Switzerland.
Int J Cancer, 78 (1998), pp. 315-319
[7.]
R.L. Travers, A.J. Sober, M. Berwick, M.C.J. Mihm, R.L. Barnhill, L.M. Duncan, et al.
Increased thickness of pregnancy-associated melanoma.
Br J Dermatol, 132 (1995), pp. 876-883
[8.]
S. Agarwala, W. Ferri, W. Gooding, J. Kirkwood.
A phase III randomized trial of dacarbazine and carboplatin with and without tamoxifen in the treatment of patients with metastatic melanoma.
Cancer, 85 (1999), pp. 1979-1984
[9.]
R. Molife, P. Lorigan, S. MacNeil.
Gender and survival in malignant tumours.
Cancer Treat Rev, 27 (2001), pp. 201-209
[10.]
P.A. Gimotty, D. Guerry, M.E. Ming, R. Elenitsas, X. Xu, B. Czerniecki, et al.
Thin primary cutaneous malignant melanoma: a prognostic tree for 10-year metastasis is more accurate than American Joint Committee on Cancer staging.
J Clin Oncol, 22 (2004), pp. 3668-3676
[11.]
U. Leiter, P.G. Buettner, T.K. Eigentler, C. Garbe.
Prognostic factors of thin cutaneous melanoma: an analysis of the central malignant melanoma registry of the german dermatological society.
J Clin Oncol, 22 (2004), pp. 3660-3667
[12.]
J.G. Miller, S. Mac Neil.
Gender and cutaneous melanoma.
Br J Dermatol, 136 (1997), pp. 657-665
[13.]
C. Garbe, P. Büttner, J. Bertz, G. Burg, B. d’Hoedt, H. Drepper, et al.
Primary cutaneous melanoma. Prognostic classification of anatomic location.
Cancer, 75 (1995), pp. 2492-2498
[14.]
K. Lasithiotakis, U. Leiter, F. Meier, T. Eigentler, G. Metzler, M. Moehrle, et al.
Age and gender are significant independent predictors of survival in primary cutaneous melanoma.
Cancer, 112 (2008), pp. 1795-1804
[15.]
W.H. Clark, D.E. Elder, D. Guerry, L.E. Braitman, B.J. Trock, D. Schultz.
Model predicting survival in stage I melanoma based on tumor progression.
J Natl Cancer Inst, 81 (1989), pp. 1893-1904
[16.]
L. Schuchter, D.J. Schultz, M. Synnestvedt, B.J. Trock, D. Guerry, D.E. Elder, et al.
A prognostic model for predicting 10-year survival in patients with primary melanoma. The pigmented lesions group.
Ann Int Med, 125 (1996), pp. 369-375
[17.]
M.A. Weinstock, B.T. Morris, J.S. Lederman, P. Bleicher, T.B. Fitzpatrick, A.J. Sober.
Effect of BANS location on the prognosis of clinical stage I melanoma: new data and metaanalysis.
Br J Dermatol, 119 (1988), pp. 559-565
[18.]
M.M. Law, J.H. Wong.
Evaluation of the prognostic significance of the site of origin of cutaneous melanoma.
Am Surg, 60 (1994), pp. 362-366
[19.]
C.L. Day, A.J. Sober, A.W. Kopf, R.A. Lew, M.C. Mihm, P. Hennessey, et al.
A prognostic model for stage I melanoma of the upper extremity: the importance of anatomic subsites in predicting recurrent disease.
Ann Surg, 193 (1981), pp. 436-440
[20.]
P. Gillgren, G. Brattström, J. Frisell, J.O. Persson, U. Ringborg, J. Hansson.
Effect of primary site on prognosis in patients with cutaneous malignant melanoma. A study using a new model to analyse anatomical locations.
Melanoma Res, 15 (2005), pp. 125-132
[21.]
D.T. Lai, J.F. Thompson, M.J. Quinn, C. Ingvar, R. Uren, R. Howman-Giles.
New route for metastatic spread of melanoma?.
Lancet, 341 (1993), pp. 302
[22.]
F. Meier, S. Will, U. Ellwanger, B. Schlagenhauff, B. Schittek, G. Rassner, et al.
Metastatic pathways and time course in the orderly progression of cutaneous melanoma.
Br J Dermatol, 147 (2002), pp. 62-70
[23.]
A. Tejera-Vaquerizo, M.V. Barrera-Vigo, I. Fernández-Canedo, N. Blazquez-Sánchez, M. Mendiola-Fernández, A. Fernández-Orland, et al.
Estudio temporal de los diferentes patrones metastásicos en la progresión del melanoma cutáneo.
Actas Dermosifiliogr, 98 (2007), pp. 531-538
[24.]
C.S. Murray, D.L. Stokon, V.R. Doherty.
Thick melanoma: the challenge persists.
Br J Dermatol, 152 (2005), pp. 104-109
[25.]
M.F. Demierre, C. Chung, D.R. Miller, A.C. Geller.
Early detection of thick melanomas in the United States: beware of the nodular subtype.
Arch Dermatol, 141 (2005), pp. 745-750
[26.]
A.J. Chamberlain, L. Fritschi, J.W. Kelly.
Nodular melanoma: patient’ perceptions of presenting feature and implications for earlier detection.
Australia Arch Dermatol, 48 (2003), pp. 694-701
[27.]
A. Tejera-Vaquerizo, M. Mendiola-Fernández, A. Fernández-Orland, E. Herrera-Ceballos.
Thick melanoma: the problem continues.
J Eur Acad Dermatol Venereol, 22 (2008), pp. 575-579
[28.]
P.F. Austin, C.W. Cruse, G. Lyman, K. Schroer, F. Glass, D.S. Reintgen.
Age as a prognostic factor in the malignant melanoma population.
Ann Surg Oncol, 1 (1994), pp. 487-494
[29.]
S.A. Oliveria, P.J. Christos, A.C. Halpern, J.A. Fine, R.L. Barnhill, M. Berwick.
Evaluation of factors associated with skin self-examination.
Cancer Epidemiol Biomarkers Prev, 8 (1999), pp. 971-978
[30.]
P.J. Christos, S.A. Oliveria, M. Berwick, D. Guerry 4th, D.E. Elder, M. Synnestvedt, et al.
Signs and symptoms of melanoma in older populations.
J Clin Epidemiol, 53 (2000), pp. 1044-1053
[31.]
C.M. Balch, S.J. Soong, J.E. Gershenwald, J.F. Thompson, D.S. Reintgen, N. Cascinelli, et al.
Prognostic factors analysis of 17,600 melanoma patients: validation of the American Joint Committee on Cancer Melanoma Staging System.
J Clin Oncol, 19 (2001), pp. 3622-3634
[32.]
U.P. Hegde, N. Chakraborty, P. Kerr, J.M. Grant-Kels.
Melanoma in the elderly patient: relevance of the aging immune system.
Clin Dermatol, 27 (2009), pp. 537-544
[33.]
C. Chao, R.C. Martin 2nd, M.I. Ross, D.S. Reintgen, M.J. Edwards, R.D. Noyes, et al.
Correlation between prognostic factors and increasing age in melanoma.
Ann Surg Oncol, 11 (2004), pp. 259-264
[34.]
A. Ferrari, A. Bono, M. Baldi, P. Collini, M. Casanova, E. Pennacchioli, et al.
Does melanoma behave differently in younger children than in adults? A retrospective study of 33 cases of childhood melanoma from a single institution.
Pediatrics, 115 (2005), pp. 649-654
[35.]
W.H. Clark, L. From, E.A. Bernardino, M.C. Mihm.
The histogenesis and biologic behavior of primary human malignant melanomas of the skin.
Cancer Res, 29 (1969), pp. 705-727
[36.]
J.H. Arrington, R.J. Reed, H. Ichinose, E.T. Krementz.
Plantar lentiginous melanoma. A distinctive variant of cutaneous malignant melanoma.
Am J Surg Pathol, 1 (1977), pp. 131-143
[37.]
W.H. Clark, E.A. Bernardino, R.J. Read, A.W. Kopt.
Acral lentiginous melanoma.
Human malignant melanomas, pp. 109-124
[38.]
J.A. Curtin, J. Friedlyand, T. Kageshita, H.N. Patel, K.J. Busam, H. Kutzner, et al.
Distinct sets of genetic alterations in melanoma.
N Engl J Med, 353 (2005), pp. 2135-2147
[39.]
J.A. Curtin, K. Busam, D. Pinkel, B.C. Bastian.
Somatic activation of Kit in distinct subtypes of melanoma.
J Clin Oncol, 24 (2006), pp. 4340-4346
[40.]
I. Zalaudek, A.A. Marghoob, A. Scope, B. Leinweber, G. Ferrara, R. Hofmann-Wellenhof, et al.
Three roots of melanoma.
Arch Dermatol, 144 (2008), pp. 1375-1378
[41.]
M.A. Hurt.
Types of melanoma?.
J Am Acad Dermatol, 58 (2008), pp. 1059-1060
[42.]
E. Sánchez-Yus, M. Herrera, R.S. Simón, L. Requena.
Pero. ¿hubo alguna vez una clasificación de Clack de los melanomas?.
Actas Dermosifiliogr, 101 (2010), pp. 19-30
[43.]
R. Botella-Estrada, O. Sanmartín.
Diferentes alteraciones genéticas causan diferentes melanomas y nuevas posibilidades terapéuticas.
Actas Dermosifiliogr, 101 (2010), pp. 394
[44.]
L.S. de Almeida, L. Requena, A. Rütten, H. Kutzner, C. Garbe, D. Pestana, et al.
Desmoplastic malignant melanoma: a clinicopathologic analysis of 113 cases.
Am J Dermatopathol, 30 (2008), pp. 207-215
[45.]
W.G. Hawkins, K.J. Busam, L. Ben-Porat, K.S. Panageas, D.G. Coit, D.E. Gyorki, et al.
Desmoplastic melanoma: a pathologically and clinically distinct form of cutaneous melanoma.
Ann Surg Oncol, 12 (2005), pp. 207-213
[46.]
A.N. Crowson, C.M. Magro, M.C. Mihm.
Prognosticators of melanoma, the melanoma report, and the sentinel lymph node.
Mod Pathol, 19 (2006), pp. S71-S87
[47.]
D.P. Livestro, A. Muzikansky, E.M. Kaine, T.J. Flotte, A.J. Sober, M.C. Mihm, et al.
Biology of desmoplastic melanoma: a case-control comparison with other melanomas.
J Clin Oncol, 23 (2005), pp. 6739-6746
[48.]
M.W. Ludgate, D.R. Fullen, J. Lee, R. Rees, M.S. Sabel, S.L. Wong, et al.
Animal-type melanoma: a clinical and histopathological study of 22 cases from a single institution.
Br J Dermatol, 162 (2010), pp. 129-136
[49.]
R.L. Barnhill, K. Gupta.
Unusual variant of malignant melanoma.
Clin Dermatol, 27 (2009), pp. 564-587
[50.]
D. Elder.
Tumor progression, early diagnosis and prognosis of melanoma.
Acta Oncol, 38 (1999), pp. 535-547
[51.]
R.L. Barnhill, J.A. Fine, G.C. Roush, M. Berwick.
Predicting five-year outcome for patients with cutaneous melanoma in a population-based study.
Cancer, 78 (1996), pp. 427-432
[52.]
I. Bedrosian, M.B. Faries, D. Guerry 4th, R. Elenitsas, L. Schuchter, R. Mick, et al.
Incidence of sentinel node metastases in patients with thin primary melanoma (< or=1mm) with vertical growth phase.
Ann Surg Oncol, 7 (2000), pp. 251-252
[53.]
S.B. Kesmodel, G.C. Karakousis, J.D. Botbyl, R.J. Canter, R.T. Lewis, P.M. Wahl, et al.
Mitotic rate as a predictor of sentinel lymph node positivity in patients with thin melanomas.
Ann Surg Oncol, 12 (2005), pp. 449-458
[54.]
C. Requena, R. Botella-Estrada, V. Traves, E. Nagore, S. Almenar, C. Guillén.
Regresión en el melanoma: problemas en su definición e implicación pronóstica.
Actas Dermosifiliogr, 100 (2009), pp. 759-766
[55.]
S. Kang, R.L. Barnhill, M.C. Mihm, A.J. Sober.
Histologic regression in malignant melanoma: an interobserver concordance study.
J Cutan Pathol, 46 (1993), pp. 126-129
[56.]
S.G. Ronan, A.M. Eng, H.A. Briele, N.N. Shioura, T.K. Das Gupta.
Thin melanoma with regression and metastases.
Arch Dermatol, 123 (1987), pp. 1326-1330
[57.]
H.M. Shaw, J.K. Rivers, S.W. McCarthy, W.H. McCarthy.
Cutaneous melanomas exhibiting unusual biologic behavior.
World J Surg, 16 (1992), pp. 196-202
[58.]
J. Guitar, L. Lowe, M. Piepkorn, V.G. Prieto, M.S. Rabkin, S.G. Ronan, et al.
Histological characteristics of metastasizing thin melanomas: a case-control study of 43 cases.
Arch Dermatol, 138 (2002), pp. 603-608
[59.]
J.W. Kelly, R.W. Sagebiel, M.S. Blois.
Regression in malignant melanoma. A histological feature without independent prognostic significance.
Cancer, 56 (1985), pp. 2287-2291
[60.]
V.J. McGovern, H.M. Shaw, G.W. Milton.
Prognosis in patients with thin malignant melanoma: influece of regression.
Histopathology, 7 (1983), pp. 673-680
[61.]
C.G. Clemente, M.C. Mihm, R. Bufalino, S. Zurrida, P. Colline, N. Cascinelli.
Prognostic value of tumor infiltrating lymphocytes in the vertical growth phase of primary cutaneous melanoma.
Cancer, 77 (1996), pp. 1303-1310
[62.]
R.J. Tuthill, J.M. Unger, P.Y. Liu, L.E. Flaherty, V.K. Sondak.
Risk assessment in localized primary cutaneous melanoma: a Southwest Oncology Group study evaluating nine factors and a test of the Clark logistic regression prediction model.
Am J Clin Pathol, 118 (2002), pp. 504-511
[63.]
R.C. Taylor, A. Patel, K.S. Panageas, K.J. Busam, M.S. Brady.
Tumor-infiltrating lymphocytes predict sentinel lymph node positivity in patients with cutaneous melanoma.
J Clin Oncol, 25 (2007), pp. 869-875
[64.]
C.L. Day, T.J. Harris, F. Gorstein, A.J. Sober, R.A. Lew, R.J. Friedman, et al.
Malignant melanoma. Prognostic significance of “microscopic satellites” in the reticular dermis and subcutaneous flat.
Ann Surg, 194 (1981), pp. 108-112
[65.]
T.F. Kimsey, T. Cohen, A. Patel, K.J. Busam, M.S. Brady.
Microscopic satellitosis in patients with primary cutaneous melanoma: implications for nodal basin staging.
Ann Surg Oncol, 16 (2009), pp. 1176-1183
[66.]
U.N. Rao, J. Ibrahim, L.E. Flaherty, J. Richards, J.M. Kirkwood.
Implications of microscopic satellites of the primary and extracapsular lymph node spread in patients with high-risk melanoma: pathologic corollary of Eastern Cooperative Oncology Group Trial E1690.
J Clin Oncol, 20 (2002), pp. 2053-2057
[67.]
L. Shaikh, R.W. Sagebiel, C.M. Ferreira, M. Nosrati, J.R. Miller, M. Kashani-Sabet.
The role of microsatellites as a prognostic factor in primary malignant melanoma.
Arch Dermatol, 141 (2005), pp. 739-742
[68.]
M. Skobe, T. Hawighorst, D.G. Jackson, R. Prevo, L. Janes, P. Velasco, et al.
Induction of tumor lymphangiogenesis by VEGF-C promotes breast cancer metastasis.
Nat Med, 7 (2001), pp. 192-198
[69.]
M. Rinderknecht, M. Detmar.
Tumor lymphangiogenesis and melanoma metastasis.
J Cell Physiol, 216 (2008), pp. 347-354
[70.]
S.A. Stacker, C. Caesar, M.E. Baldwin, G.E. Thornton, R.A. Williams, R. Prevo, et al.
VEGF-D promotes the metastatic spread of tumor cells via the lymphatics.
Nat Med, 7 (2001), pp. 186-191
[71.]
D. Massi, S. Puig, A. Franchi, J. Malvehy, S. Vidal-Sicart, M. González-Cao, et al.
Tumour lymphangiogenesis is a possible predictor of sentinel lymph node status in cutaneous melanoma: a case-control study.
J Clin Pathol, 59 (2006), pp. 166-173
[72.]
S.S. Dadras, B. Lange-Asschenfeldt, P. Velasco, L. Nguyen, A. Vora, A. Muzikansky, et al.
Tumor lymphangiogenesis predicts melanoma metastasis to sentinel lymph nodes.
Mol Pathol, 18 (2005), pp. 1232-1242
[73.]
S.S. Dadras, T. Paul, J. Bertoncini, L.F. Brown, A. Muzikansky, D.G. Jackson, et al.
Tumor lymphangiogenesis: a novel prognosis indicator for cutaneous melanoma metastasis and survival.
Am J Pathol, 162 (2003), pp. 1951-1960
[74.]
M. Thorn, F. Ponten, R. Bergstrom, P. Sparen, H.O. Adami.
Clinical and histopathologic predictors of survival in patients with malignant melanoma: a population-based study in Sweden.
J Natl Cancer Ins, 86 (1994), pp. 761-769
[75.]
M. Kashani-Sabet, R.W. Sagebiel, C.M. Ferreira, M. Nosrati, J.R. Miller.
Vascular involvement in the prognosis of primary cutaneous melanoma.
Arch Dermatol, 137 (2001), pp. 1169-1173
[76.]
O. Straume, L.A. Akslen.
Independent prognostic importance of vascular invasion in nodular melanomas.
Cancer, 78 (1996), pp. 1211-1219
[77.]
R. Barnhill, K. Dy, C. Lugassy.
Angiotropism in cutaneous melanoma: a prognostic factor strongly predicting risk for metastasis.
J Invest Dermatol, 119 (2002), pp. 705-706
[78.]
S.L. Van Es, M. Colman, J.F. Thompson, S.W. McCarthy, R.A. Scolyer.
Angiotropism is an independent predictor of local recurrence and in-transit metastasis in primary cutaneous melanoma.
Am J Surg Pathol, 32 (2008), pp. 1396-1403
[79.]
H.E. Newlin, C.G. Morris, R.J. Amdur, W.M. Medenhall.
Neurotropic melanoma of the head and neck with clinical perineural invasion.
Am J Clin Oncol, 28 (2005), pp. 399-402
[80.]
M.J. Quinn, K.A. Crotty, J.F. Thompson, A.S. Coates, C.J. O’Brien, W.H. McCarthy.
Desmoplastic and desmoplastic neutropic melanoma.
Cancer, 83 (1998), pp. 1128-1135
[81.]
J.Y. Chen, G. Hruby, R.A. Scolyer, R. Murali, A. Hong, P. Fitzgerald, et al.
Desmoplastic neurotropic melanoma: a clinicopathologic analysis of 128 cases.
Cancer, 113 (2008), pp. 2770-2778
[82.]
T.E. Larsen, T.H. Grude.
A retrospective histological study of 669 cases of primary cutaneous malignant melanoma in clinical stage I. 2. The relation of cell type, pigmentation, atypia and mitotic count to histological type and prognosis.
Acta Pathol Microbiol Scand A, 86A (1978), pp. 513-522
[83.]
C. Schmoeckel, A. Bockelbrink, H. Bockelbrink, J. Koutsis, O. Braun-Falco.
Low- and high-risk malignant melanoma--I. Evaluation of clinical and histological prognosticators in 585 cases.
Eur J Cancer Clin Oncol, 19 (1983), pp. 227-235
[84.]
E. Drunkenmolle, W. Marsch, D. Lubbe, P. Helmbold.
Paratumoral epidermal hyperplasia: a novel prognostic factor in thick primary melanoma of the skin?.
Am J Pathol, 27 (2005), pp. 482-488
[85.]
A. Masback, H. Olsson, J. Westerdahl, C. Ingvar, N. Jonsson.
Prognostic factors in invasive cutaneous malignant melanoma: a population-based study and review.
Melanoma Res, 11 (2001), pp. 435-445
[86.]
R.M. McKie, T. Aitchison, J.M. Sirel, K. McLaren, D.C. Watt.
Prognostic models for subgroups of melanoma patients from the Scottish Melanoma Group database 1979–86, and their subsequent validation.
Br J Cancer, 71 (1995), pp. 173-176
[87.]
S. Kaddu, J. Smolle, P. Zenahlik, R. Hofmann-Wellenhof, H. Kerl.
Melanoma with benign melanocytic naevus components: reappraisal of clinicopathological features and prognosis.
Melanoma Res, 12 (2002), pp. 271-278
[88.]
B. Echeverría, R. Botella-Estrada, C. Serra-Guillén, A. Martorell, V. Traves, C. Requena, et al.
Riesgo aumentado del desarrollo de un segundo melanoma cutáneo primario sobre un nevo en pacientes diagnosticados previamente de un melanoma cutáneo primario sobre nevo.
Actas Dermosifiliogr, 101 (2010), pp. 710-716
[89.]
F.A. Cuéllar, A. Vilalta, R. Rull, S. Vidal-Sicart, J. Palou, P.J. Ventura, et al.
Small cell melanoma and ulceration as predictors of positive sentinel lymph node in malignant melanoma patients.
Melanoma Res, 14 (2004), pp. 277-282
[90.]
J.J. Grob, M.A. Richard, J. Gouvernet, M.F. Avril, M. Delaunay, P. Wolkenstein.
The kinetics of the visible growth of a primary melanoma reflects the tumor aggressiveness and is an independent prognostic marker: a prospective study.
Int J Cancer, 102 (2002), pp. 34-38
[91.]
W. Liu, J.P. Dowling, W.K. Murray, G.A. McArthur, J.F. Thompson, R. Wolfe, et al.
Rate of growth in melanomas: characteristics and associations of rapidly growing melanomas.
Arch Dermatol, 142 (2006), pp. 1551-1558
[92.]
A. Tejera-Vaquerizo, M.V. Barrera-Vigo, N. López-Navarro, E. Herrera-Ceballos.
Growth rate as a prognostic factor in localized invasive cutaneous melanoma.
J Eur Acad Dermatol Venereol, 24 (2010), pp. 147-156
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