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Definition
of Clark level of invasion
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Clark
level of invasion:
A method for determining the prognosis
(outlook) with melanoma.
The method was devised by the pathologist
Wallace Clark and measures the depth of penetration of
a melanoma
into the skin
according to anatomic layer.
There are five Clark levels of invasion:
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Level I: Melanomas confined to the outermost layer of
the skin, the epidermis.
Also called "melanoma in-situ."
- Level
II: Penetration by melanomas into the second layer of
the skin, the dermis.
- Levels
III-IV: Melanomas invade deeper through the dermis,
but are still contained completely within the skin.
- Level
V: Penetration of melanoma into the fat
of the skin beneath the dermis, penetration into the
third layer of the skin, the subcutis.
The Clark levels provide a system to relate the degree
of penetration of melanoma into the skin to the 5-year
survival rate after surgical removal of the melanoma.
Another melanoma measurement system, that of Breslow
thickness, named after its originator Alexander Breslow,
is in wider use today. In it, invasive tumor
thickness is used to predict 5-year survival. For example,
a thickness of the melanoma of less than 0.76 millimeters
is associated with a 5-year survival of 97% of patients
whereas a tumor thickness of more than 8.0 millimeters
is associated with 5-year survival of 32%.
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