INTRODUCTION: Histological evidence of primary tumor regression (RG) is observed in 35% or fewer patients with cutaneous melanoma. Some advocate a lower threshold for sentinel lymph node (SLN) biopsy when RG is present. METHODS: We identified 1,349 patients presenting to our center with clinically localized cutaneous melanoma between 1995 and 2004. Of these, 344 demonstrated histological RG in their primary melanoma. A retrospective analysis of their medical records was performed to obtain clinical and pathological information. RESULTS: The median Breslow depth for the 344 patients with RG was 1.1 mm versus 1.5 mm for 1,005 patients with no regression (NRG) (P < 0.005). SLN biopsy was performed in 64% of patients with RG and 72% without. Positive SLN was more common in those with NRG than in those with RG (18% vs 10%, P = 0.005). Only one RG patient with thin melanoma (</=1 mm, Clark IV) had a positive SLN. When stratified by Breslow depth, patients with RG had lower rates of SLN positivity in all groups (</=1.0mm, >1.0 and </=2.0mm, >2 and </=4 mm, and >4.0 mm). Recurrence was more common in patients with NRG (21% vs 12%; P < 0.005). Both local and systemic recurrence occurred more commonly in patients with NRG (4% vs 1%, P = 0.002 and 8% vs 3%, P < 0.005, respectively) CONCLUSIONS: The presence of histological RG in a primary melanoma predicts neither SLN positivity when stratified by Breslow depth nor increased risk of recurrence when compared with melanomas with NRG.
INTRODUCTION: Histological evidence of primary tumor regression (RG) is observed in 35% or fewer patients with cutaneous melanoma. Some advocate a lower threshold for sentinel lymph node (SLN) biopsy when RG is present. METHODS: We identified 1,349 patients presenting to our center with clinically localized cutaneous melanoma between 1995 and 2004. Of these, 344 demonstrated histological RG in their primary melanoma. A retrospective analysis of their medical records was performed to obtain clinical and pathological information. RESULTS: The median Breslow depth for the 344 patients with RG was 1.1 mm versus 1.5 mm for 1,005 patients with no regression (NRG) (P < 0.005). SLN biopsy was performed in 64% of patients with RG and 72% without. Positive SLN was more common in those with NRG than in those with RG (18% vs 10%, P = 0.005). Only one RG patient with thin melanoma (</=1 mm, Clark IV) had a positive SLN. When stratified by Breslow depth, patients with RG had lower rates of SLN positivity in all groups (</=1.0mm, >1.0 and </=2.0mm, >2 and </=4 mm, and >4.0 mm). Recurrence was more common in patients with NRG (21% vs 12%; P < 0.005). Both local and systemic recurrence occurred more commonly in patients with NRG (4% vs 1%, P = 0.002 and 8% vs 3%, P < 0.005, respectively) CONCLUSIONS: The presence of histological RG in a primary melanoma predicts neither SLN positivity when stratified by Breslow depth nor increased risk of recurrence when compared with melanomas with NRG.
Authors: Michelle W Ma; Ratna C Medicherla; Meng Qian; Eleazar Vega-Saenz de Miera; Erica B Friedman; Russell S Berman; Richard L Shapiro; Anna C Pavlick; Patrick A Ott; Nina Bhardwaj; Yongzhao Shao; Iman Osman; Farbod Darvishian Journal: Mod Pathol Date: 2012-03-16 Impact factor: 7.842
Authors: Richard L White; Gregory D Ayers; Virginia H Stell; Shouluan Ding; Jeffrey E Gershenwald; Jonathan C Salo; Barbara A Pockaj; Richard Essner; Mark Faries; Kim James Charney; Eli Avisar; Axel Hauschild; Friederike Egberts; Bruce J Averbook; Carlos A Garberoglio; John T Vetto; Merrick I Ross; David Chu; Vijay Trisal; Harald Hoekstra; Eric Whitman; Harold J Wanebo; Daniel Debonis; Michael Vezeridis; Aaron Chevinsky; Mohammed Kashani-Sabet; Yu Shyr; Lynne Berry; Zhiguo Zhao; Seng-Jaw Soong; Stanley P L Leong Journal: Ann Surg Oncol Date: 2011-06-07 Impact factor: 5.344
Authors: Melanie A Warycha; Paul J Christos; Madhu Mazumdar; Farbod Darvishian; Richard L Shapiro; Russell S Berman; Anna C Pavlick; Alfred W Kopf; David Polsky; Iman Osman Journal: Cancer Date: 2008-12-15 Impact factor: 6.860