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| Clark
6-parameter Prognosis Tables |
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Clark's 6-Parameter Melanoma Prognostic Index
Use on Stage I, Vertical Growth Phase
Primary Cutaneous Melanoma Cases
8-Year Survival Probabilities
(and 95% confidence intervals) |
| It is our standard intent that all pathology reports of biopsies
or excisions of primary cutaneous malignant melanoma contain exacting
measures and interpretations such that any patient and/or his/her
treating doctor might be able to use the tables below to calculate
a general prognosis. That is, these tables suggest (from data
on a large number of cases) the prognosis of a group of patients
with findings thought to be similar to your findings. There has been
one study claiming a formula [here] for use to calculate the prognosis
for a specific (your personal) case. Furthermore, you can go to a
page in our web site and use your pathology report data to
get other general "prognostic information" for cases
with features similar to yours. |
If 2,
in 1 Breslow thickness less
than 1.70 mm.: |
| |
Survival Probability (95% Confidence
Interval) |
|
Female |
Male |
| Mitotic rate/mm2 |
Tumor-infiltrating lymphocytes |
Tumor regression |
Extremities |
Axial/subvolar |
Extremities |
Axial/subvolar |
| 0.0 |
Brisk |
Absent |
1.0 (0.99-1.0) |
1.0 (0.96-1.0) |
1.0 (0.97-1.0) |
0.99 (0.91-1.0) |
| |
|
Present |
1.0 (0.97-1.0) |
0.99 (0.92-1.0) |
0.99 (0.93-1.0) |
0.96 (0.81-0.99) |
| |
Nonbrisk |
Absent |
1.0 (0.97-1.0) |
0.98 (0.92-1.0) |
0.99 (0.93-1.0) |
0.96 (0.81-0.99) |
| |
|
Present |
0.99 (0.93-1.0) |
0.96 (0.80-0.99) |
0.97 (0.83-0.99) |
0.89 (0.60-0.98) |
| |
Absent |
Absent |
0.99 (0.93-1.0) |
0.95 (0.78-0.99) |
0.96 (0.82-0.99) |
0.86-(0.57-0.97) |
| |
|
Present |
0.96 (0.81-0.99) |
0.87 (0.54-0.97) |
0.89 (0.59-0.98) |
0.69 (0.30-0.92) |
| 0.1-6.0 |
Brisk |
Absent |
1.0 (0.98-1.0) |
0.98 (0.94-1.0) |
0.99 (0.94-1.0) |
0.95 (0.85-0.99) |
| |
|
Present |
0.99 (0.95-1.0) |
0.96 (0.86-0.99) |
0.97 (0.87-0.99) |
0.88 (0.70-0.96) |
| |
Nonbrisk |
Absent |
0.99 (0.96-1.0) |
0.95 (0.87-0.98) |
0.96 (0.88-0.99) |
0.87 (0.71-0.94) |
| |
|
Present |
0.96 (0.89-0.99) |
0.87 (0.71-0.95) |
0.90 (0.72-0.97) |
0.70 (0.47-0.86) |
| |
Absent |
Absent |
0.95 (0.88-0.98) |
0.84 (0.68-0.93) |
0.87 (0.70-0.95) |
0.65 (0.43-0.82) |
| |
|
Present |
0.88 (0.69-0.96) |
0.66 (0.40-0.85) |
0.71 (0.42-0.90) |
0.40 (0.19-0.65) |
| >6.0 |
Brisk |
Absent |
0.99 (0.93-1.0) |
0.95 (0.79-0.99) |
0.96 (0.82-0.99) |
0.86 (0.58-0.96) |
| |
|
Present |
0.96 (0.84-0.99) |
0.86 (0.61-0.96) |
0.89 (0.64-0.97) |
0.68 (0.37-0.88) |
| |
Nonbrisk |
Absent |
0.95 (0.85-0.99) |
0.84 (0.62-0.95) |
0.88 (0.66-0.96) |
0.65 (0.37-0.85) |
| |
|
Present |
0.88 (0.68-0.96) |
0.66 (0.38-0.86) |
0.72 (0.41-0.90) |
0.40 (0.18-0.66) |
| |
Absent |
Absent |
0.85 (0.66-0.95) |
0.61 (0.35-0.81) |
0.67 (0.38-0.86) |
0.34 (0.16-0.59) |
| |
|
Present |
0.68 (0.38-0.88) |
0.35 (0.15-0.63) |
0.42 (0.17-0.72) |
0.16 (0.06-0.37) |
|
if 2, in 1 Breslow
thickness greater than 1.70 mm.: |
| |
Survival Probability (95% Confidence
Interval) |
|
Female |
Male |
| Mitotic
rate/mm2 |
Tumor-infiltrating
lymphocytes |
Tumor
regression |
Extremities |
Axial/subvolar |
Extremities |
Axial/subvolar |
| 0.0 |
Brisk |
Absent |
0.99
(0.95-1.0) |
0.98
(0.86-1.0) |
0.98
(0.88-1.0) |
0.95
(0.69-0.99) |
| |
|
Present |
0.99
(0.89-1.0) |
0.95
(0.70-0.99) |
0.96
(0.74-0.99) |
0.86
(0.47-0.98) |
| |
Nonbrisk |
Absent |
0.98
(0.90-1.0) |
0.94
(0.71-0.99) |
0.95
(0.76-0.99) |
0.84
(0.47-0.97) |
| |
|
Present
|
0.95
(0.75-0.99) |
0.85
(0.46-0.97) |
0.88
(0.52-0.98) |
0.66
(0.24-0.92) |
| |
Absent
|
Absent |
0.94
(0.73-0.99) |
0.82
(0.43-0.96) |
0.85
(0.49-0.97) |
0.60
(0.21-0.90) |
| |
|
Present
|
0.86
(0.47-0.98) |
0.61
(0.19-0.91) |
0.67
(0.23-0.93) |
0.35
(0.08-0.77) |
| 0.1-6.0 |
Brisk |
Absent |
0.98
(0.93-1.0) |
0.94
(0.80-0.98) |
0.95
(0.82-0.99) |
0.84
(0.60-0.95) |
| |
|
Present |
0.95
(0.84-0.99) |
0.84
(0.62-0.95) |
0.87
(0.65-0.96) |
0.65
(0.38-0.84) |
| |
Nonbrisk |
Absent |
0.95
(0.87-0.98) |
0.82
(0.65-0.92) |
0.86
(0.69-0.94) |
0.61
(0.42-0.78) |
| |
|
Present |
0.86
(0.69-0.95) |
0.62
(0.40-0.81) |
0.68
(0.43-0.86) |
0.36
(0.20-0.57) |
| |
Absent |
Absent |
0.83
(0.66-0.93) |
0.57
(0.36-0.76) |
0.63
(0.39-0.82) |
0.31
(0.17-0.51) |
| |
|
Present |
0.64
(0.37-0.85) |
0.32
(0.14-0.57) |
0.38
(0.16-0.67) |
0.14
(0.06-0.31) |
| >6.0 |
Brisk |
Absent |
0.94
(0.78-0.99) |
0.81
(0.51-0.95) |
0.85
(0.56-0.96) |
0.60
(0.28-0.85) |
| |
|
Present |
0.85
(0.60-0.96) |
0.61
(0.31-0.84) |
0.67
(0.34-0.89) |
0.35
(0.14-0.63) |
| |
Nonbrisk |
Absent |
0.84
(0.65-0.93) |
0.57
(0.33-0.78) |
0.63
(0.38-0.83) |
0.31
(0.16-0.53) |
| |
|
Present |
0.64
(0.39-0.84) |
0.32
(0.15-0.56) |
0.38
(0.17-0.65) |
0.14
(0.06-0.29) |
| |
Absent |
Absent |
0.59
(0.36-0.78) |
0.28
(0.13-0.49) |
0.33
(0.15-0.57) |
0.12
(0.05-0.24) |
| |
|
Present |
0.34
(0.15-0.61) |
0.12
(0.05-0.28) |
0.15
(0.05-0.36) |
0.04
(0.02-0.12) |
|
References:
-
Halpern AC, Schuchter LM, Prognostic Models
in Melanoma, Seminars in Oncology, 24(1 suppl. 4):S2-7, Feb.
1997.
-
Clark WH, J. Natl. Ca. Inst. 81:1893-1904,
1989.
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1999 - 2006, all rights reserved, Pathology Associates Of Lexington,
P.A. |
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