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Alexander J. Chamberlain, MBBS; Lin Fritschi, MBBS, PhD; Graham G. Giles, PhD, MSc; John P. Dowling, MBBS; John W. Kelly, MDBS

Arch Dermatol. 2002;138:609-614.

Objectives  To explore the clinical associations of thick melanoma and to compare the clinicopathological variables of nodular and superficial spreading types.

Design  Cross-sectional study of all invasive primary melanomas recorded by the Victorian Cancer Registry for 1998 and those reviewed by the Victorian Melanoma Service between October 1, 1994, and April 31, 1999.

Setting  Population-based cancer registry and public hospital–based multidisciplinary melanoma clinic.

Patients  This study included 1422 patients recorded by the Victorian Cancer Registry and 674 patients who had attended the Victorian Melanoma Service; unclassifiable tumor types were excluded, leaving 1144 and 645 patients, respectively, eligible for analysis.

Main Outcome Measures  Melanomas were categorized by thickness into thin (1 mm), intermediate (>1-3 mm), and thick (>3 mm) and compared according to patient age, sex, and tumor type and site. Superficial spreading and nodular types were also compared in this manner. Use of the Victorian Melanoma Service database enabled a more comprehensive analysis of historical and phenotypic characteristics.

Results  Thick melanoma was predominantly nodular, occurring in older men, mostly on the head and neck and associated with fewer nevi. Nodular melanoma was thicker and found mostly on the lower limbs or head and neck; it had a greater association with a history of solar keratoses than did superficial spreading melanoma.

Conclusion  Nodular type and older age are the most significant associations of thick melanoma.

From the Victorian Melanoma Service (Drs Chamberlain, Dowling, and Kelly), the Department of Epidemiology and Preventive Medicine, Monash University (Dr Fritschi), and the Department of Anatomical Pathology, Alfred Hospital (Dr Dowling), Prahran, Victoria, Australia; and the Cancer Epidemiology Centre, Anti-Cancer Council of Victoria, Carlton, Victoria (Dr Giles). Dr Chamberlain is currently with the Department of Dermatology, Churchill Hospital, Oxford Radcliffe NHS Trust, Oxford, England, and Dr Fritschi is currently with the Department of Public Health, University of Western Australia, Nedlands.

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