D Dias-Santagata1, M A Selim2, Y Su1, Y Peng3, R Vollmer2, A Chłopik4, G Tell-Marti5, K M Paral2, S C Shalin6, C R Shea7, S Puig5, M T Fernandez-Figueras8, W Biernat9, J Ryś10, A Marszalek4, M P Hoang1. 1. Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, U.S.A. 2. Duke University Medical Center, Durham, NC, U.S.A. 3. University of Texas Southwestern Medical Center, Dallas, TX, U.S.A. 4. Poznan University Medical Sciences and Greater Poland Cancer Center, Poznan, Poland. 5. Department of Dermatology, Melanoma Unit, Hospital Clínic de Barcelona, IDIBAPS, and Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain. 6. University of Arkansas for Medical Sciences, Little Rock, AR, U.S.A. 7. Department of Medicine, Section of Dermatology, University of Chicago, IL, U.S.A. 8. Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain. 9. Medical University of Gdansk, Gdansk, Poland. 10. Center of Oncology, M. Sklodowska-Curie Memorial Institute, Krakow, Poland.
Abstract
BACKGROUND: Few studies have addressed prognostic markers and none has correlated molecular status and prognosis in vulvar melanomas. OBJECTIVES: To evaluate the clinicopathological features of 95 cases of vulvar melanoma. METHODS: p53, CD117, Ki-67, neurofibromin, brafv600e and nrasq61r immunostains, and molecular analyses by either targeted next-generation or direct sequencing, were performed on available archival materials. RESULTS: Molecular testing detected mutations in KIT (44%), BRAF (25%), NF1 (22%), TP53 (17%), NRAS (9%) and TERT promoter (9%). Co-mutation of KIT and NF1 and of KIT and NRAS were identified in two and one cases, respectively. KIT mutations were significantly associated with better progression-free survival in univariate analyses. In multivariate analyses CD117 expression was significantly associated with better progression-free survival. Tumour thickness was significantly associated with worse progression-free and overall survival, and perineural invasion significantly correlated with reduced melanoma-specific survival and reduced overall survival. Cases were from multiple centres and only a subset of samples was available for molecular testing. CONCLUSIONS: KIT mutations and CD117 overexpression are markers of better progression-free survival. In addition to its prognostic value, molecular testing may identify cases that might respond to targeted agents or immunotherapeutic approaches.
BACKGROUND: Few studies have addressed prognostic markers and none has correlated molecular status and prognosis in vulvar melanomas. OBJECTIVES: To evaluate the clinicopathological features of 95 cases of vulvar melanoma. METHODS:p53, CD117, Ki-67, neurofibromin, brafv600e and nrasq61r immunostains, and molecular analyses by either targeted next-generation or direct sequencing, were performed on available archival materials. RESULTS: Molecular testing detected mutations in KIT (44%), BRAF (25%), NF1 (22%), TP53 (17%), NRAS (9%) and TERT promoter (9%). Co-mutation of KIT and NF1 and of KIT and NRAS were identified in two and one cases, respectively. KIT mutations were significantly associated with better progression-free survival in univariate analyses. In multivariate analyses CD117 expression was significantly associated with better progression-free survival. Tumour thickness was significantly associated with worse progression-free and overall survival, and perineural invasion significantly correlated with reduced melanoma-specific survival and reduced overall survival. Cases were from multiple centres and only a subset of samples was available for molecular testing. CONCLUSIONS:KIT mutations and CD117 overexpression are markers of better progression-free survival. In addition to its prognostic value, molecular testing may identify cases that might respond to targeted agents or immunotherapeutic approaches.
Authors: Mitul B Modi; Phyllis A Gimotty; Michael E Ming; Neha Jariwala; Rosalie Elenitsas; Chris Miller; Emily Y Chu; Hanna Lindner; Ata S Moshiri; Lauren E Schwartz; Priti Lal; Maria C Reyes; David E Elder; Xiaowei Xu Journal: Hum Pathol Date: 2020-07-20 Impact factor: 3.466
Authors: Tiago Bordeira Gaspar; Ana Sá; José Manuel Lopes; Manuel Sobrinho-Simões; Paula Soares; João Vinagre Journal: Genes (Basel) Date: 2018-05-03 Impact factor: 4.096