Stevan R Knezevich1, Raymond L Barnhill2, David E Elder3, Michael W Piepkorn4, Lisa M Reisch5, Gaia Pocobelli5, Patricia A Carney6, Joann G Elmore5. 1. Veterans Affairs Medical Center, Seattle, Washington; Department of Pathology, University of Washington School of Medicine, Seattle, Washington. Electronic address: stevanrk@gmail.com. 2. Department of Pathology, University of California at Los Angeles, Los Angeles, California. 3. Department of Pathology, University of Pennsylvania, Philadelphia, Pennsylvania. 4. Division of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington; Dermatopathology Northwest, Bellevue, Washington. 5. Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington. 6. Departments of Family Medicine and Public Health and Preventive Medicine, Oregon Health and Sciences University, Portland, Oregon.
Abstract
BACKGROUND: T1 melanoma staging is significantly affected by tissue sampling approaches, which have not been well characterized. OBJECTIVE: We sought to characterize presence of mitotic figures across a minimum of 5 sequential sections of T1 melanomas. METHODS: A cohort of T1 melanomas with either 5 (single section per slide) or 10 (2 sections per slide) sequential sections (5-μm thickness) per case were prepared and examined for mitotic figures. RESULTS: In all, 44 of 82 T1 melanomas (54%) were classified as T1b. The number of sections with a mitotic figure present ranged from only 1 of 5 sections (n = 5 of 44 cases, 11.4%) to all 5 (n = 20 of 44 cases, 45.5%). A sequential approach versus a nonsequential approach did not appear to matter. LIMITATION: Cases were taken from a single pathology practice in the Pacific Northwest, which may not generalize to other populations in the United States. CONCLUSION: The variation in the presence of mitotic figures within sequential sections supports reviewing 3 to 5 sections to fulfill American Joint Committee on Cancer recommendations. The prognostic significance of a T1b melanoma with a rare mitotic figure on a single section versus a T1b melanoma with mitotic figures on multiple sections deserves more attention to see if further subclassification is possible or even necessary.
BACKGROUND: T1 melanoma staging is significantly affected by tissue sampling approaches, which have not been well characterized. OBJECTIVE: We sought to characterize presence of mitotic figures across a minimum of 5 sequential sections of T1 melanomas. METHODS: A cohort of T1 melanomas with either 5 (single section per slide) or 10 (2 sections per slide) sequential sections (5-μm thickness) per case were prepared and examined for mitotic figures. RESULTS: In all, 44 of 82 T1 melanomas (54%) were classified as T1b. The number of sections with a mitotic figure present ranged from only 1 of 5 sections (n = 5 of 44 cases, 11.4%) to all 5 (n = 20 of 44 cases, 45.5%). A sequential approach versus a nonsequential approach did not appear to matter. LIMITATION: Cases were taken from a single pathology practice in the Pacific Northwest, which may not generalize to other populations in the United States. CONCLUSION: The variation in the presence of mitotic figures within sequential sections supports reviewing 3 to 5 sections to fulfill American Joint Committee on Cancer recommendations. The prognostic significance of a T1b melanoma with a rare mitotic figure on a single section versus a T1b melanoma with mitotic figures on multiple sections deserves more attention to see if further subclassification is possible or even necessary.
Authors: Michael W Piepkorn; Raymond L Barnhill; David E Elder; Stevan R Knezevich; Patricia A Carney; Lisa M Reisch; Joann G Elmore Journal: J Am Acad Dermatol Date: 2013-10-28 Impact factor: 11.527
Authors: David J Casper; Kate I Ross; Jane L Messina; Vernon K Sondak; Cheryl N Bodden; Tim W McCardle; L Frank Glass Journal: Am J Dermatopathol Date: 2010-10 Impact factor: 1.533
Authors: Richard A Scolyer; Helen M Shaw; John F Thompson; Ling-Xi L Li; Marjorie H Colman; Sing Kai Lo; Stanley W McCarthy; A Allan Palmer; Katherine D Nicoll; Bish Dutta; Eric Slobedman; Geoff F Watson; Jonathan R Stretch Journal: Am J Surg Pathol Date: 2003-12 Impact factor: 6.394
Authors: Patricia A Carney; Lisa M Reisch; Michael W Piepkorn; Raymond L Barnhill; David E Elder; Stevan Knezevich; Berta M Geller; Gary Longton; Joann G Elmore Journal: J Cutan Pathol Date: 2016-07-01 Impact factor: 1.587
Authors: David E Elder; Michael W Piepkorn; Raymond L Barnhill; Gary M Longton; Heidi D Nelson; Stevan R Knezevich; Margaret S Pepe; Patricia A Carney; Linda J Titus; Tracy Onega; Anna N A Tosteson; Martin A Weinstock; Joann G Elmore Journal: J Am Acad Dermatol Date: 2018-03-07 Impact factor: 11.527
Authors: A Caldarella; L Fancelli; G Manneschi; A Chiarugi; P Nardini; E Crocetti Journal: J Cancer Res Clin Oncol Date: 2015-06-26 Impact factor: 4.553
Authors: Patricia A Carney; Paul D Frederick; Lisa M Reisch; Linda Titus; Stevan R Knezevich; Martin A Weinstock; Michael W Piepkorn; Raymond L Barnhill; David E Elder; Donald L Weaver; Joann G Elmore Journal: J Cutan Pathol Date: 2018-04-26 Impact factor: 1.587
Authors: Laura A Taylor; Megan M Eguchi; Lisa M Reisch; Andrea C Radick; Hannah Shucard; Kathleen F Kerr; Michael W Piepkorn; Stevan R Knezevich; David E Elder; Raymond L Barnhill; Joann G Elmore Journal: Cancer Date: 2021-05-04 Impact factor: 6.860
Authors: Joann G Elmore; Raymond L Barnhill; David E Elder; Gary M Longton; Margaret S Pepe; Lisa M Reisch; Patricia A Carney; Linda J Titus; Heidi D Nelson; Tracy Onega; Anna N A Tosteson; Martin A Weinstock; Stevan R Knezevich; Michael W Piepkorn Journal: BMJ Date: 2017-06-28