Mitotic rate correlates with sentinel lymph node status and outcome in cutaneous melanoma greater than 1 millimeter in thickness: A multi-institutional study of 1524 cases - 18/04/17
on behalf of
Italian Melanoma Intergroup
Abstract |
Background |
The 7th edition of the TNM American Joint Committee on Cancer classification incorporates mitotic rate (MR) only for primary cutaneous melanoma (PCM) with Breslow thickness (BT) ≤1 mm.
Objective |
To investigate whether and to what extent MR is able to predict sentinel lymph node (SLN) status and clinical outcome of PCM patients with BT >1 mm.
Methods |
The study included consecutive patients with PCM. Logistic regression and Cox regression model were used to analyze the impact of MR on SLN status, disease-free survival (DFS), and overall survival.
Results |
From 1998 to 2015, 1524 PCM (median age 57.8 years) cases were diagnosed with a BT >1 mm in six centers of the Italian Melanoma Intergroup. Median follow-up was 5.0 years. By multivariate analysis, MR was associated with SLN positivity (odds ratio 1.98, 95% confidence interval [CI] 1.12-3.50, P = .018). After adjusting for BT, ulceration, age, sex, and SLN status, MR correlated with a poor DFS (hazard ratio 1.52, 95% CI 1.18-1.97, P = .002) and overall survival (hazard ratio 1.63, 95% CI 1.17-2.29, P = .004).
Limitations |
Retrospective analysis.
Conclusion |
MR is an independent prognostic factor for PCM patients with BT >1 mm. Incorporating this tissue biomarker could provide a better stratification of patients entering clinical trials in the adjuvant setting.
Le texte complet de cet article est disponible en PDF.Key words : mitotic rate, cutaneous melanoma, prognosis, disease-free survival, overall survival, sentinel lymph node, outcome
Abbreviations used : AJCC, BT, CI, DFS, HR, IMI, IQR, MR, OR, OS, PCM, SLN, TILs
Plan
Drs Tondini and Queirolo equally contributed senior authorship. |
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Reprints not available from the authors. |
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Supplemental items available at www.jaad.org/. |
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Supported by Italian Melanoma Intergroup (IMI, grant 3/2015), the Italian network for melanoma treatment and research (www.melanomaimi.it/), grant number IMI 18NOV2014-17NOV2015. |
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Conflict of interest: None. |
Vol 76 - N° 2
P. 264 - février 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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