Mario Mandalà1, Francesca Galli2, Laura Cattaneo3, Barbara Merelli4, Eliana Rulli2, Simone Ribero5, Pietro Quaglino5, Vincenzo De Giorgi6, Jacopo Pigozzo7, Vanna Chiarion Sileni7, Alessandra Chirco4, Pier Francesco Ferrucci8, Marcella Occelli9, Gianlorenzo Imberti10, Dario Piazzalunga11, Daniela Massi12, Carlo Tondini4, Paola Queirolo13. 1. Unit of Medical Oncology, Papa Giovanni XXIII Hospital, Bergamo, Italy. Electronic address: mariomandala@tin.it. 2. Methodology for Clinical Research Laboratory, IRCCS, Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy. 3. Unit of Pathology, Papa Giovanni XXIII Hospital, Bergamo, Italy. 4. Unit of Medical Oncology, Papa Giovanni XXIII Hospital, Bergamo, Italy. 5. Section of Dermatology, Medical Sciences Department, Dermatologic Clinic, University of Turin, Turin, Italy. 6. Department of Dermatology, University of Florence, Florence, Italy. 7. Unit of Medical Oncology, Istituto Oncologico Veneto, Padua, Italy. 8. Medical Oncology of Melanoma, European Institute of Oncology, Milan, Italy. 9. Azienda Ospedaliera Santa Croce e Carle di Cuneo SC Oncologia, Cuneo, Italy. 10. Unit of Dermatology, Papa Giovanni XXIII Hospital, Bergamo, Italy. 11. Unit of Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy. 12. Division of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. 13. Department of Medical Oncology, National Institute for Cancer Research, IRCCS San Martino, Genoa, Italy.
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.
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.
Authors: Jeffrey E Gershenwald; Richard A Scolyer; Kenneth R Hess; Vernon K Sondak; Georgina V Long; Merrick I Ross; Alexander J Lazar; Mark B Faries; John M Kirkwood; Grant A McArthur; Lauren E Haydu; Alexander M M Eggermont; Keith T Flaherty; Charles M Balch; John F Thompson Journal: CA Cancer J Clin Date: 2017-10-13 Impact factor: 508.702
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Authors: Alberto Julius Alves Wainstein; João Pedreira Duprat Neto; Mauro Yoshiaki Enokihara; Eduard René Brechtbühl; Felice Riccardi; Gilles Landman; Andreia Cristina de Melo; Vinicius de Lima Vazquez; Rodrigo Ramella Munhoz; Ivan Dunshee De Abranches Oliveira Santos Filho; Eduardo Bertolli; Ana Paula Drummond-Lage; Bianca Costa Soares de Sá; Luciane Botelho; Jose Higino Steck; Francisco Aparecido Belfort; Marcus Maia; Renato Marchiori Bakos; Elimar Elias Gomes; Rafael Schmerling; Flavio Cavarsan Journal: JCO Glob Oncol Date: 2020-04