Abstract:
Introduction. Cutaneous malignant melanoma is a biologically heterogeneous neoplasm characterized
by marked variability in clinical behaviour and prognosis. Although, multiple histopathologic
parameters are incorporated into contemporary risk stratification models, tumour thickness remains
one of the most reliable predictors of disease progression and patient outcome. Evaluation of its
association with additional clinicopathologic features may further fortify its role as a key determinant
in melanoma aggressiveness. The present study assesses the prognostic significance of tumour
thickness in superficial spreading melanoma by analysing its correlations with established markers of
tumour progression.
Materials and Methods. A retrospective analysis was performed on 47 cases of superficial spreading
melanoma obtained from the Oncology Institute of Chisinau. All specimens underwent comprehensive
histopathologic review to assess tumour thickness, Clark level, ulceration, mitotic activity,
microsatellitosis, pigmentation status, and lymph node involvement. Tumour thickness was measured
on routine haematoxylin–eosin-stained slides. Statistical analysis of correlations between tumour
thickness and clinicopathologic features was performed using Pearson correlation coefficients, with
significance defined as p ≤ 0.05. Results. The cohort included 47 patients with a mean age of 65.6 ±
12.15 years; 24 patients (51.1%) were female and 23 (48.9%) were male. Pigmented melanomas
accounted for 34 cases (72.3%), while 13 cases (27.7%) were non-pigmented. Tumour thickness
demonstrated statistically significant positive correlations with several indicators of tumour
aggressiveness, including Clark level (r = 0.60, p = 0.001), ulceration (r = 0.29, p = 0.03),
lymphovascular invasion (r = 0.54, p = 0.001), microsatellitosis (r = 0.36, p = 0.01), and advanced
tumour stage (r = 0.45, p = 0.001). In contrast, tumour thickness showed a significant inverse
correlation with pigmentation status (r = −0.42, p = 0.05), indicating that thicker tumours were more
frequently non-pigmented. No additional clinicopathologic parameters reached statistical significance
level.
Conclusions. Tumour thickness is strongly associated with multiple histopathologic features of
aggressive behaviour in superficial spreading melanoma. Its correlation with invasive parameters and
advanced tumour stage, along with its inverse association with pigmentation, underscores its central
prognostic value. These findings support the continued use of tumour thickness as a key prognostic
marker and highlight the importance of integrating morphologic parameters in melanoma risk
stratification.
