Invasive potential of cutaneous malignant melanoma

Abstract

Introduction. Cutaneous malignant melanoma is the most aggressive skin cancer, with a high mortality rate despite advances in therapy. This study aimed to evaluate the relationship between lymphovascular and perineural invasion and key clinicopathological parameters in superficial spreading melanoma, in order to assess their potential prognostic significance.

Materials and methods. A retrospective analysis was conducted on 47 cases of superficial spreading melanoma obtained from the Oncology Institute in Chisinau. All cases were histologically confirmed and reviewed for tumor thickness, Clark level, ulceration, mitotic activity, microsatellitosis, pigmentation, and lymph node involvement. Lymphovascular and perineural invasion were assessed using hematoxylin–eosin staining and, where available, immunohistochemistry. Correlations between invasion patterns and clinicopathologic features were analyzed using Pearson correlation coefficients, with statistical significance set at p < 0.05.

Results. Lymphovascular invasion was positive and significantly correlated with tumor thickness (r = 0.54, p< 0.001), Clark level (r = 0.46, p < 0.001), microsatellitosis (r = 0.50, p < 0.001), tumor stage (r = 0.33, p = 0.01), and lymph node involvement (r = 0.29, p = 0.02). A negative correlation was observed with pigmentation (r = –0.26, p = 0.04). Perineural invasion was less frequent, but correlated positively with lymphovascular invasion (r = 0.28, p = 0.03) and showed a trend toward association with amelanotic tumors (r = –0.24, p = 0.05). No significant relationships were found with ulceration or mitotic activity.

Conclusions. Lymphovascular invasion represents a significant indicator of aggressive biological behavior in superficial spreading melanoma, closely associated with established prognostic factors. Perineural invasion occurs less frequently, but may further reflect invasive potential, particularly in amelanotic variants. Routine histopathologic assessment of both invasion patterns is recommended to improve prognostic evaluation.