An update on reporting histopathologic prognostic factors in melanoma

Context.-Accurate diagnosis of melanocytic lesions is essential for the adequate clinical management of patients. Thus, thorough reporting of histopathologic parameters, especially in the initial biopsies, is a critical component of both diagnosis and staging. Objective.-To review current data on histopathologic prognostic factors for melanoma, with special emphasis on their use and applicability to clinical practice. Special attention is focused on the criteria highlighted by the new 2009 version of The American Joint Committee on Cancer (AJCC) system of melanoma staging and classification. Data Sources.-Published peer-reviewed literature and personal experience of the authors. Conclusions.-When reporting melanoma, we recommend that a template be provided, including all the histologic parameters that have been proved significant in determining the tumor staging and prognosis of a patient. The template may also include other details that may be helpful in further analysis of potential complete excisional biopsies or metastatic lesions, such as predominant type of tumor cells, presence or absence of desmoplastic component, or associated benign melanocytic lesions. Although there are several drawbacks in reporting some of these histopathologic parameters (interobserver variability, occasional lack of a perfectly reproducible method for quantifyingthese criteria), we suggest that at least the essential histopathologic parameters highlighted by the newest version of the AJCC system for melanoma staging and classification should be included in the report.