Melanomas are skin tumors that show a variety of biological behavior. Some develop very fast and some other grow extremely slow, with metastasis appearing, eventually, many years after the diagnosis. The number of mitoses in primary melanoma has been related to a more aggressive tumor and may have a potential as predictive factor for cutaneous melanoma survival. However, tumor mitotic rate is a static measure and in multivariate analysis on tumor survival, it has scored less than other tumor characteristics. We tried to evolve tumor mitotic rate from a static parameter to a time‐dependent one. Similar to the already described growth rate (GR), we propose the speed rate (SR). SR is defined as the ratio of tumor mitotic rate to time to melanoma development. A prospective series of 345 patients with melanoma was investigated for the role of SR as predictive factor for sentinel lymph node (SLN) positivity and tumor progression. We calculated the best threshold for SR and GR to predict the risk of recurrence. Melanoma clinical and histological characteristics as well as GR were correlated in a multivariated analysis with SR. SR values >0.2 mitoses/month were associated with negative prognostic factors such as ulceration (82.8%), SLN positivity (80%), progression (82.8%), and death (85.7%). The association of GR > 0.3 mm/months and SR > 0.2 mitoses/month had a significant predictive value in terms of SLN positivity, progression, and recurrence‐free survival. We propose SR as a new “dynamic” predictor of histological SLN positivity and melanoma recurrence risk. We think that he association with this new feature with GR may be helpful in improving the accuracy of predicted clinical outcome of patient especially with thin melanomas.

中文翻译：

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速度（SR）作为黑色素瘤行为的新动态指标。

黑色素瘤是表现出多种生物学行为的皮肤肿瘤。有些发展很快，而另一些发展得非常缓慢，最终在诊断后很多年出现转移。原发性黑色素瘤中有丝分裂的数量与更具侵略性的肿瘤有关，可能具有皮肤黑色素瘤存活的预测因素。然而，肿瘤的有丝分裂率是一项静态指标，在对肿瘤存活率的多变量分析中，其得分低于其他肿瘤特征。我们试图将肿瘤的有丝分裂率从静态参数发展为与时间相关的参数。与已经描述的增长率（GR）相似，我们提出了速度（SR）。SR定义为肿瘤有丝分裂率与黑色素瘤发展时间的比率。对345名黑色素瘤患者的前瞻性系列进行了研究，以探讨SR作为前哨淋巴结（SLN）阳性和肿瘤进展的预测因素的作用。我们计算了SR和GR的最佳阈值，以预测复发风险。黑色素瘤的临床和组织学特征以及GR与SR的多变量分析相关。SR值> 0.2有丝分裂/月与负预后因素有关，例如溃疡（82.8％），SLN阳性（80％），进展（82.8％）和死亡（85.7％）。就SLN阳性，进展和无复发生存而言，GR> 0.3 mm /月和SR> 0.2有丝分裂/月的关联具有显着的预测价值。我们建议SR作为组织学SLN阳性和黑色素瘤复发风险的新“动态”预测指标。