[Malignant melanomas of Lille 1967-1972. Comparison between "histoprognosis" and actual outcome (author's transl)]. / Mélanomes malins lillois 1967-1872. Confrontation entre l'histopronostic et le devenir réel

This work groups 126 cases of malignant melanomas operated since 1967. Seventy-seven cases responding to 2 criterions were selected: reexamination of the primary pathologic sample of melanoma according to 4 tests of histoprognosis and adequate follow-up of the patient. Histoprognostic criterions according to Clark and Mihm were the histogenetic type, the level of invasion plus vascular embolic neoplastic invasion and the notion of mitotic index. Four main conclusions emerged: Statistical notion of a critical period situated between the 12th and 30th month, during which 40% of patients die, especially those with primary tumor of histogenetic type NM (nodular melanoma) or SSM (superficial spreading melanoma) and invasion stage IV and V. Assurance of the value of histoprognosis in the primary cognition of tumoral determinism. A new precision in the decision of systematic node excision in invasion stages IV and V, and in stages III with high mitotic index. Reasonable and early use of all therapeutic means in cases with unfavourable histoprognosis.