Predictive models of melanoma metastasis based on dermatoscopy in an international retrospective human reader study

Current melanoma prognostic tools have limited clinical use at the bedside, highlighting the need for more effective biomarkers. Dermatoscopy correlates with established prognostic markers obtained through invasive procedures. However, its direct predictive value for metastasis remains unexplored. In this multinational study, 30 dermatologists evaluated 776 dermatoscopic images of melanomas (stage IB and above) for predefined criteria including structures, colors and vessels. Extensive dermatoscopic ulceration and blue-white veil are associated with increased risk of metastasis in the total cohort and reduced recurrence-free survival in early-stage melanomas, while extensive regression is associated with reduced metastasis risk and improved recurrence-free survival. Three predictive models of metastasis: (1) dermatoscopic features only, (2) histopathologic features only, and (3) a combination of both demonstrate comparable prognostic accuracy. Here, we show that dermatoscopy may offer valuable prognostic insights into melanoma's biological behavior before excision and help guide therapeutic decisions. Prospective validation in future trials is essential.

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Publication Details

Journal
Nature Communications
Published
2025-12-08
DOI
https://doi.org/10.1038/s41467-025-65972-w
Primary Topic
Cutaneous Melanoma Detection and Management
Type
article
Field-Weighted Citation Impact
0.00

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article

Predictive models of melanoma metastasis based on dermatoscopy in an international retrospective human reader study

Harald Kittler, Konstantinos Lallas, Emi Dika, Konstantinos Liopyris et al.
Nature Communications
Cutaneous Melanoma Detection and Management
article

Predictive models of melanoma metastasis based on dermatoscopy in an international retrospective human reader study

Harald Kittler, Konstantinos Lallas, Emi Dika, Konstantinos Liopyris, Manuela Martins Costa, Emilia N. Cohen Sabban, Giulia Briatico, Aurora Alessandrini, Timothy J. Liu, H. Peter Soyer, Ralph P. Braun, Philipp Tschandl, Akane Minagawa, Félix Pham, Masaru Tanaka, Clare E. Mahon, Josep Malvehy, Dana Shalmon, Victoria Mar, Teresa Amaral, Aimilios Lallas, Alon Scope, Marina Agozzino, Giuseppe Argenziano, Renato Marchiori Bakos, Alex J Chamberlain, Susana Puig, L. Thomas, Zoé Apalla, Iris Zalaudek, Efstratios Vakirlis, Cristina Vico‐Alonso, N. Muller, Ashfaq A. Marghoob, Wilhelm Stolz, Horacio Cabo
article en

Abstract

Current melanoma prognostic tools have limited clinical use at the bedside, highlighting the need for more effective biomarkers. Dermatoscopy correlates with established prognostic markers obtained through invasive procedures. However, its direct predictive value for metastasis remains unexplored. In this multinational study, 30 dermatologists evaluated 776 dermatoscopic images of melanomas (stage IB and above) for predefined criteria including structures, colors and vessels. Extensive dermatoscopic ulceration and blue-white veil are associated with increased risk of metastasis in the total cohort and reduced recurrence-free survival in early-stage melanomas, while extensive regression is associated with reduced metastasis risk and improved recurrence-free survival. Three predictive models of metastasis: (1) dermatoscopic features only, (2) histopathologic features only, and (3) a combination of both demonstrate comparable prognostic accuracy. Here, we show that dermatoscopy may offer valuable prognostic insights into melanoma's biological behavior before excision and help guide therapeutic decisions. Prospective validation in future trials is essential.

Nature CommunicationsVol. 16(1)
Universidade Federal do Rio Grande do Sul (BR), Memorial Sloan Kettering Cancer Center (US), University of Trieste (IT), Tel Aviv University (IL), The University of Queensland (AU), Aristotle University of Thessaloniki (GR), Universidad de Buenos Aires (AR), Sheba Medical Center (IL), The Alfred Hospital (AU), Victorian Infectious Diseases Reference Laboratory (AU), IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT), University Hospital of Zurich (CH), Hospices Civils de Lyon (FR), Hôpital Lyon Sud (FR), Hospital Clínic de Barcelona (ES), München Klinik (DE), Andreas Sygros Hospital (GR), University of Campania "Luigi Vanvitelli" (IT), Tokyo Women's Medical University Adachi Medical Center (JP), Tokyo Women's Medical University (JP), Medical University of Vienna (AT), University of Tübingen (DE)
Aristotle University of Thessaloniki
Openalex Percentile: Top 46%
Cutaneous Melanoma Detection and Management
DOIOpen Access PDFOpenAlex
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