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<p>Current melanoma prognostic tools have limited clinical use at the bedside, highlighting the need for more effective biomarkers. Dermatoscopy correlates with established prognostic markers obtained through invasive procedures. However, its direct predictive value for metastasis remains unexplored. In this multinational study, 30 dermatologists evaluated 776 dermatoscopic images of melanomas (stage IB and above) for predefined criteria including structures, colors and vessels. Extensive dermatoscopic ulceration and blue-white veil are associated with increased risk of metastasis in the total cohort and reduced recurrence-free survival in early-stage melanomas, while extensive regression is associated with reduced metastasis risk and improved recurrence-free survival. Three predictive models of metastasis: (1) dermatoscopic features only, (2) histopathologic features only, and (3) a combination of both demonstrate comparable prognostic accuracy. Here, we show that dermatoscopy may offer valuable prognostic insights into melanoma’s biological behavior before excision and help guide therapeutic decisions. Prospective validation in future trials is essential.</p>

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Predictive models of melanoma metastasis based on dermatoscopy in an international retrospective human reader study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月8日

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  • Konstantinos Lallas,
  • Harald Kittler,
  • Philipp Tschandl,
  • Konstantinos Liopyris,
  • Teresa Amaral,
  • Giuseppe Argenziano,
  • Renato Marchiori Bakos,
  • Ralph Braun,
  • Horacio Cabo,
  • Emi Dika,
  • Josep Malvehy,
  • Ashfaq Marghoob,
  • Susana Puig,
  • Alon Scope,
  • Wilhelm Stolz,
  • Akane Minagawa,
  • Manuela Martins Costa,
  • Marina Agozzino,
  • Dana Shalmon,
  • Giulia Briatico,
  • Emilia Noemi Cohen Sabban,
  • Victoria Mar,
  • Clare Mahon,
  • Nicholas M. Muller,
  • Masaru Tanaka,
  • Timothy Liu,
  • Felix Pham,
  • Aurora Alessandrini,
  • Alex Chamberlain,
  • Cristina Vico-Alonso,
  • Luc Thomas,
  • H. Peter Soyer,
  • Zoe Apalla,
  • Efstrations Vakirlis,
  • Iris Zalaudek,
  • Aimilios Lallas

摘要

Current melanoma prognostic tools have limited clinical use at the bedside, highlighting the need for more effective biomarkers. Dermatoscopy correlates with established prognostic markers obtained through invasive procedures. However, its direct predictive value for metastasis remains unexplored. In this multinational study, 30 dermatologists evaluated 776 dermatoscopic images of melanomas (stage IB and above) for predefined criteria including structures, colors and vessels. Extensive dermatoscopic ulceration and blue-white veil are associated with increased risk of metastasis in the total cohort and reduced recurrence-free survival in early-stage melanomas, while extensive regression is associated with reduced metastasis risk and improved recurrence-free survival. Three predictive models of metastasis: (1) dermatoscopic features only, (2) histopathologic features only, and (3) a combination of both demonstrate comparable prognostic accuracy. Here, we show that dermatoscopy may offer valuable prognostic insights into melanoma’s biological behavior before excision and help guide therapeutic decisions. Prospective validation in future trials is essential.