Mitotic rate is associated with positive lymph nodes in patients with thin melanomas - 19/04/18
Abstract |
Background |
The American Joint Commission on Cancer will remove mitotic rate from its staging guidelines in 2018.
Objective |
Using a large nationally representative cohort, we examined the association between mitotic rate and lymph node positivity among thin melanomas.
Methods |
A total of 149,273 thin melanomas in the National Cancer Database were examined for their association of high-risk features of mitotic rate, ulceration, and Breslow depth with lymph node status.
Results |
Among 17,204 patients with thin melanomas with data on Breslow depth, ulceration, and mitotic rate who underwent a lymph node biopsy, there was a strong linear relationship between odds of having a positive lymph node and mitotic rate (R2 = 0.96, P < .0001, β = 3.31). The odds of having a positive node increased by 19% with each 1-point increase in mitotic rate (odds ratio, 1.19; 95% confidence interval, 1.17-1.21). Cases with negative nodes had a mean mitotic rate of 1.54 plus or minus 2.07 mitoses/mm2 compared with 3.30 plus or minus 3.54 mitoses/mm2 for those with positive nodes (P < .0001).
Limitations |
The data collected do not allow for survival analyses.
Conclusions |
Mitotic rate was strongly associated with the odds of having a positive lymph node and should continue to be reported on pathology reports.
Le texte complet de cet article est disponible en PDF.Key words : clinical research, guidelines, melanoma, mitotic rate, skin cancer, staging
Abbreviations used : AJCC, CI, NCDB, OR, SLNB
Plan
Funding sources: None. |
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Conflicts of interest: None disclosed. |
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Reprints not available from the authors. |
Vol 78 - N° 5
P. 935-941 - mai 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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