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

Author

Listed:
  • Konstantinos Lallas

    (Faculty of Health Sciences, Aristotle University, Department of Medical Oncology, School of Medicine)

  • Harald Kittler

    (Department of Dermatology, Medical University of Vienna)

  • Philipp Tschandl

    (Department of Dermatology, Medical University of Vienna)

  • Konstantinos Liopyris

    (Andreas Syggros Hospital of Cutaneous & Venereal Diseases, University of Athens, Department of Dermatology)

  • Teresa Amaral

    (Eberhard Karls University of Tübingen, Skin Cancer Clinical Trials Center, Department of Dermatology)

  • Giuseppe Argenziano

    (Dermatology Unit, University of Campania L. Vanvitelli)

  • Renato Marchiori Bakos

    (Department of Dermatology, Universidade Federal do Rio Grande do Sul)

  • Ralph Braun

    (Department of Dermatology, University Hospital Zurich)

  • Horacio Cabo

    (Universidad de Buenos Aires, Universidad de Buenos Aires)

  • Emi Dika

    (Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi)

  • Josep Malvehy

    (Dermatology Department, Hospital Clínic Barcelona)

  • Ashfaq Marghoob

    (Memorial Sloan Kettering Skin Cancer Center, Memorial Sloan Kettering Skin Cancer Center)

  • Susana Puig

    (Dermatology Department, Hospital Clínic Barcelona)

  • Alon Scope

    (Medical Screening Institute, Chaim Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine)

  • Wilhelm Stolz

    (Department of Dermatology, Allergology and Environmental Medicine, Clinic Thalkrichner Strasse)

  • Akane Minagawa

    (Department of Dermatology, Tokyo Women’s Medical University Adachi Medical Center)

  • Manuela Martins Costa

    (Department of Dermatology, Universidade Federal do Rio Grande do Sul)

  • Marina Agozzino

    (Department of Dermatology and Venerology, Medical University of Trieste)

  • Dana Shalmon

    (and Tel Aviv University Faculty of Medical and Health Sciences, The Kittner Skin Cancer Screening and Research Center, Sheba Medical Center, Ramat Gan)

  • Giulia Briatico

    (Dermatology Unit, University of Campania L. Vanvitelli)

  • Emilia Noemi Cohen Sabban

    (Universidad de Buenos Aires, Universidad de Buenos Aires)

  • Victoria Mar

    (The Alfred Hospital, Victorian Melanoma Service)

  • Clare Mahon

    (Dermatology Research Centre, Frazer Institute, The University of Queensland)

  • Nicholas M. Muller

    (Dermatology Research Centre, Frazer Institute, The University of Queensland)

  • Masaru Tanaka

    (Department of Dermatology, Tokyo Women’s Medical University Adachi Medical Center)

  • Timothy Liu

    (Dermatology Research Centre, Frazer Institute, The University of Queensland)

  • Felix Pham

    (Hôpital Lyon Sud, Hospices Civils de Lyon, Department of Dermatology)

  • Aurora Alessandrini

    (Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi)

  • Alex Chamberlain

    (Glenferrien Dermatology)

  • Cristina Vico-Alonso

    (The Alfred Hospital, Victorian Melanoma Service)

  • Luc Thomas

    (Hôpital Lyon Sud, Hospices Civils de Lyon, Department of Dermatology)

  • H. Peter Soyer

    (Dermatology Research Centre, Frazer Institute, The University of Queensland)

  • Zoe Apalla

    (Faculty of Health Sciences, Aristotle University, Second Department of Dermatology, School of Medicine)

  • Efstrations Vakirlis

    (Faculty of Health Sciences, Aristotle University, First Department of Dermatology, School of Medicine)

  • Iris Zalaudek

    (Department of Dermatology and Venerology, Medical University of Trieste)

  • Aimilios Lallas

    (Faculty of Health Sciences, Aristotle University, First Department of Dermatology, School of Medicine)

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.

Suggested Citation

  • Konstantinos Lallas & Harald Kittler & Philipp Tschandl & Konstantinos Liopyris & Teresa Amaral & Giuseppe Argenziano & Renato Marchiori Bakos & Ralph Braun & Horacio Cabo & Emi Dika & Josep Malvehy &, 2025. "Predictive models of melanoma metastasis based on dermatoscopy in an international retrospective human reader study," Nature Communications, Nature, vol. 16(1), pages 1-12, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-65972-w
    DOI: 10.1038/s41467-025-65972-w
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