Ulceration

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    • November 27, 2015 at 2:52 am
    gregor913
    Participant

      Can somebody please explain to me ulceration. I mean if it has spread to your lymph nodes why is it worse or even significant. Are the cells more aggressive? Are the tumors always worse? I know it carries a worse prognosis but why? Been looking on the internet and cant find out the reason. The only thing I found was a study that said ulcerated melanomas tend to have a higher mitotic rate.  Anyone know?
       

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        • November 27, 2015 at 3:13 am
        Janner
        Participant

          I do not know the reason why, or even if that has ever been established.  Ulceration is when the skin's epidermal structure has been compromised.  What has been established, however, is that patients with ulceration have done worse statistically than those without.  There are studies looking at outcome based on many characteristics.  These studies provide information for new staging criteria.  That is why it is included in staging because ulceration showed statistical significance when lesions with/without ulceration were studied.

          • November 27, 2015 at 3:13 am
          Janner
          Participant

            I do not know the reason why, or even if that has ever been established.  Ulceration is when the skin's epidermal structure has been compromised.  What has been established, however, is that patients with ulceration have done worse statistically than those without.  There are studies looking at outcome based on many characteristics.  These studies provide information for new staging criteria.  That is why it is included in staging because ulceration showed statistical significance when lesions with/without ulceration were studied.

            • November 27, 2015 at 3:13 am
            Janner
            Participant

              I do not know the reason why, or even if that has ever been established.  Ulceration is when the skin's epidermal structure has been compromised.  What has been established, however, is that patients with ulceration have done worse statistically than those without.  There are studies looking at outcome based on many characteristics.  These studies provide information for new staging criteria.  That is why it is included in staging because ulceration showed statistical significance when lesions with/without ulceration were studied.

              • November 29, 2015 at 9:36 pm
              gregor913
              Participant
                I know ulceration tends to be worse prognosis. Are the cells of a ulcerated tumor tend to be more aggressive? I’m just trying to figure out how it relates to stage 2 and 3 . Especially stage 3 once it’s in the lymph nodes. I mean do the cells act differently from a 3a patient. I always thought a melanoma cell is a melanoma cell. Is there any correlation between a ulcerated tumor and say breslow depth or mitotic rate.
                • November 29, 2015 at 9:36 pm
                gregor913
                Participant
                  I know ulceration tends to be worse prognosis. Are the cells of a ulcerated tumor tend to be more aggressive? I’m just trying to figure out how it relates to stage 2 and 3 . Especially stage 3 once it’s in the lymph nodes. I mean do the cells act differently from a 3a patient. I always thought a melanoma cell is a melanoma cell. Is there any correlation between a ulcerated tumor and say breslow depth or mitotic rate.
                  • November 29, 2015 at 9:36 pm
                  gregor913
                  Participant
                    I know ulceration tends to be worse prognosis. Are the cells of a ulcerated tumor tend to be more aggressive? I’m just trying to figure out how it relates to stage 2 and 3 . Especially stage 3 once it’s in the lymph nodes. I mean do the cells act differently from a 3a patient. I always thought a melanoma cell is a melanoma cell. Is there any correlation between a ulcerated tumor and say breslow depth or mitotic rate.
                      • November 30, 2015 at 3:32 am
                      CHD
                      Participant

                        Just wanted to point out that the article linked to above does explain a possible connection between mitotic rate and ulceration:

                        "Ulceration is an indicator of unfavourable prognosis in malignant melanoma (MM). But why do melanomas ulcerate?. Possible causes of ulceration were investigated in a group of 69 ulcerated and 69 non-ulcerated malignant melanomas. A significant correlation (P less than 0.001) between ulceration and mitotic index was found. In a group of 69 ulcerated malignant melanomas, 49 had over 7, 15 had 4-6, and only 5 had 0-3 mitotic figures per 10 high-power fields. Among 69 non-ulcerated melanomas, 28 had more than 7, 24 had 4-6, and 17 had 0-3 mitotic figures per 10 high-power fields. This study supports the hypothesis that ulceration of melanomas is usually the result of the destruction of the epidermis by the proliferating neoplastic cells or modification of blood supply due to the expansile activity of the tumor. The relationship between ulceration and mitotic activity helps clarify the prognostic significance of ulceration"

                        I have not heard any other theories on why ulcerated tumors are associated with a poorer prognosis. 

                        Best wishes to you.

                        • November 30, 2015 at 3:32 am
                        CHD
                        Participant

                          Just wanted to point out that the article linked to above does explain a possible connection between mitotic rate and ulceration:

                          "Ulceration is an indicator of unfavourable prognosis in malignant melanoma (MM). But why do melanomas ulcerate?. Possible causes of ulceration were investigated in a group of 69 ulcerated and 69 non-ulcerated malignant melanomas. A significant correlation (P less than 0.001) between ulceration and mitotic index was found. In a group of 69 ulcerated malignant melanomas, 49 had over 7, 15 had 4-6, and only 5 had 0-3 mitotic figures per 10 high-power fields. Among 69 non-ulcerated melanomas, 28 had more than 7, 24 had 4-6, and 17 had 0-3 mitotic figures per 10 high-power fields. This study supports the hypothesis that ulceration of melanomas is usually the result of the destruction of the epidermis by the proliferating neoplastic cells or modification of blood supply due to the expansile activity of the tumor. The relationship between ulceration and mitotic activity helps clarify the prognostic significance of ulceration"

                          I have not heard any other theories on why ulcerated tumors are associated with a poorer prognosis. 

                          Best wishes to you.

                          • November 30, 2015 at 3:32 am
                          CHD
                          Participant

                            Just wanted to point out that the article linked to above does explain a possible connection between mitotic rate and ulceration:

                            "Ulceration is an indicator of unfavourable prognosis in malignant melanoma (MM). But why do melanomas ulcerate?. Possible causes of ulceration were investigated in a group of 69 ulcerated and 69 non-ulcerated malignant melanomas. A significant correlation (P less than 0.001) between ulceration and mitotic index was found. In a group of 69 ulcerated malignant melanomas, 49 had over 7, 15 had 4-6, and only 5 had 0-3 mitotic figures per 10 high-power fields. Among 69 non-ulcerated melanomas, 28 had more than 7, 24 had 4-6, and 17 had 0-3 mitotic figures per 10 high-power fields. This study supports the hypothesis that ulceration of melanomas is usually the result of the destruction of the epidermis by the proliferating neoplastic cells or modification of blood supply due to the expansile activity of the tumor. The relationship between ulceration and mitotic activity helps clarify the prognostic significance of ulceration"

                            I have not heard any other theories on why ulcerated tumors are associated with a poorer prognosis. 

                            Best wishes to you.

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