{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T22:48:39Z","timestamp":1766011719500,"version":"3.48.0"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T00:00:00Z","timestamp":1727827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breslow thickness (BT), ulceration, and microsatellitosis are critical prognostic parameters for cutaneous melanoma staging. These parameters can vary depending on the number of tissue levels examined from individual paraffin blocks. We sought to evaluate all prognostic histopathologic parameters in melanoma for their variations between levels, taken at regular intervals, in a single study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 40 consecutive cases of primary cutaneous (nonacral) melanoma through five hematoxylin and eosin sections, taken at 100\u2009\u03bcm intervals, for staging and prognostic parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Examination of additional levels resulted in (a) an increase in BT in 47.5% (19 out of 40) of cases and (b) detection of ulceration in a further 5% (2\/40). This resulted in upstaging for 20% (8 out of 40) of patients (15% because of BT, 2.5% because of ulceration, and 2.5% because of BT and ulceration). The upstaging effect was incremental, with approximately 5% of patients upstaged with each additional 100\u2009\u03bcm interval (up to 400\u2009\u03bcm). Incipient ulceration and epidermal consumption were infrequent (10% of cases); however, when present, ulceration was subsequently observed in half of cases. We encountered no cases where microsatellitosis was detected at deeper levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The performance of additional tissue levels is a simple and inexpensive procedure that can improve the accuracy of staging for patients with thin (pT1) primary cutaneous melanomas. It may be pertinent for pathologists to consider additional levels for thin melanomas when a BT measurement is close to a staging threshold (e.g., within 0.1\u20130.3\u2009mm for pT1a vs. pT1b, or pT1b vs. pT2a), or when incipient ulceration is encountered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cup.14726","type":"journal-article","created":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T20:53:44Z","timestamp":1727902424000},"page":"71-80","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Multiple Tissue Levels Frequently Upstages Patients With Clinically Localized Thin Primary Cutaneous Melanoma"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2792-6199","authenticated-orcid":false,"given":"Louise A.","family":"Jackett","sequence":"first","affiliation":[{"name":"Department of Anatomical Pathology Peter MacCallum Cancer Centre  Melbourne Victoria Australia"},{"name":"Melanoma Institute Australia, The University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James P.","family":"Gullifer","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology Peter MacCallum Cancer Centre  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8991-0013","authenticated-orcid":false,"given":"Richard A.","family":"Scolyer","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia, The University of Sydney  Sydney New South Wales Australia"},{"name":"Tissue Pathology and Diagnostic Oncology Royal Prince Alfred Hospital &amp; NSW Health Pathology  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"},{"name":"Charles Perkins Centre The University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,2]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11196"},{"volume-title":"AJCC Cancer Staging Manual","year":"2017","author":"AJCC (American Joint Committee on Cancer)","key":"e_1_2_13_3_1"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(77)80061-0"},{"volume-title":"Primary Cutaneous Melanoma Structured Reporting Protocol","year":"2023","author":"RCPA (Royal College of Pathologists of Australasia)","key":"e_1_2_13_5_1"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31829d7f35"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/cup.13541"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.141.6.734"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13061020"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12253\u2010019\u201000635\u2010y"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097\u20100142(19831215)52:12<2338::AID\u2010CNCR2820521229>3.0.CO;2\u2010T"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2006.02.007"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100560.1996.tb01295.x"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200312000-00011"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2023.4193"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0b013e318156e0a7"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.02362"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19895"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.1998.tb01711.x"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010011\u20102208\u2010z"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1309\/MGRX\u2010LQG9\u2010QVRV\u2010VMCG"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.pas.0000213262.61855.7d"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097\u20100142(19800615)45:12<3012::aid\u2010cncr2820451223>3.0.co;2\u2010o"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31824c4b0b"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010012\u20102265\u2010y"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/23723556.2016.1253527"}],"container-title":["Journal of Cutaneous Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cup.14726","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T22:43:31Z","timestamp":1766011411000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cup.14726"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,2]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/cup.14726"],"URL":"https:\/\/doi.org\/10.1111\/cup.14726","archive":["Portico"],"relation":{},"ISSN":["0303-6987","1600-0560"],"issn-type":[{"type":"print","value":"0303-6987"},{"type":"electronic","value":"1600-0560"}],"subject":[],"published":{"date-parts":[[2024,10,2]]},"assertion":[{"value":"2024-05-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}