A Piñero-Madrona1, G Ruiz-Merino2, P Cerezuela Fuentes3, E Martínez-Barba4, J N Rodríguez-López5, J Cabezas-Herrera5. 1. Department of Surgery, Hospital Clínico Universitario "Virgen de La Arrixaca", Instituto Murciano de Investigación Biosanitaria (IMIB), El Palmar, 30120, Murcia, Spain. pineromadrona@gmail.com. 2. Department of Statistics, Hospital Clínico Universitario "Virgen de La Arrixaca", Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain. 3. Department of Oncology, Hospital Clínico Universitario "Virgen de La Arrixaca", Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain. 4. Department of Pathology, Hospital Clínico Universitario "Virgen de La Arrixaca", Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain. 5. Department of Molecular Research, Hospital Clínico Universitario "Virgen de La Arrixaca", Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain.
Abstract
BACKGROUND: Recently, the quantification of mitoses in cutaneous melanoma has been discharged from the main prognostic variables of the TNM classification. OBJECTIVE: To investigate the prognostic value of the presence of mitoses in primary cutaneous melanoma and to establish the number of mitoses per mm2 that may have prognostic significance. METHODS: A retrospective observational study was performed on 141 patients treated for cutaneous melanoma, who were assessed by the same pathologist, and who had a minimum follow-up of 2 years. Clinical, epidemiological, histopathological and follow-up variables were gathered and compared with the number of mitoses to distinguish the significance of differences by means of univariate, multivariate, and survival analyses. RESULTS: The cut-off level related to a better sensitivity and specificity was 1.50 mitoses per mm2. The presence of two or more mitoses/mm2 showed a better relationship with prognostic variables and both the overall and disease-free survival than the presence of 1 or more mitoses/mm2. This happens especially in melanomas thicker than 0.8 mm and it could affect the staging in cases with Breslow between 1 and 2 mm. CONCLUSIONS: A mitotic rate of two or more mitoses per mm2 in cutaneous melanoma should be considered as a more accurate prognostic factor than one or more mitoses per mm2, particularly in tumors equal or greater than 0.8 mm in thickness.
BACKGROUND: Recently, the quantification of mitoses in cutaneous melanoma has been discharged from the main prognostic variables of the TNM classification. OBJECTIVE: To investigate the prognostic value of the presence of mitoses in primary cutaneous melanoma and to establish the number of mitoses per mm2 that may have prognostic significance. METHODS: A retrospective observational study was performed on 141 patients treated for cutaneous melanoma, who were assessed by the same pathologist, and who had a minimum follow-up of 2 years. Clinical, epidemiological, histopathological and follow-up variables were gathered and compared with the number of mitoses to distinguish the significance of differences by means of univariate, multivariate, and survival analyses. RESULTS: The cut-off level related to a better sensitivity and specificity was 1.50 mitoses per mm2. The presence of two or more mitoses/mm2 showed a better relationship with prognostic variables and both the overall and disease-free survival than the presence of 1 or more mitoses/mm2. This happens especially in melanomas thicker than 0.8 mm and it could affect the staging in cases with Breslow between 1 and 2 mm. CONCLUSIONS: A mitotic rate of two or more mitoses per mm2 in cutaneous melanoma should be considered as a more accurate prognostic factor than one or more mitoses per mm2, particularly in tumors equal or greater than 0.8 mm in thickness.
Authors: John F Thompson; Seng-Jaw Soong; Charles M Balch; Jeffrey E Gershenwald; Shouluan Ding; Daniel G Coit; Keith T Flaherty; Phyllis A Gimotty; Timothy Johnson; Marcella M Johnson; Stanley P Leong; Merrick I Ross; David R Byrd; Natale Cascinelli; Alistair J Cochran; Alexander M Eggermont; Kelly M McMasters; Martin C Mihm; Donald L Morton; Vernon K Sondak Journal: J Clin Oncol Date: 2011-04-25 Impact factor: 44.544
Authors: Su Luo; Alice Z C Lobo; Kenneth K Tanabe; Alona Muzikansky; Tyler Durazzo; Arthur Sober; Hensin Tsao; A Benedict Cosimi; Donald P Lawrence; Lyn M Duncan Journal: JAMA Surg Date: 2015-05 Impact factor: 14.766
Authors: Allison R Larson; Brian Rothschild; Andrew C Walls; Scott R Granter; Abrar A Qureshi; George F Murphy; Alvaro C Laga Journal: J Cutan Pathol Date: 2015-05-26 Impact factor: 1.587
Authors: Patrick D Lorimer; Emily C Benham; Kendall Walsh; Yimei Han; Meghan R Forster; Terry Sarantou; Richard L White; Joshua S Hill Journal: J Surg Oncol Date: 2017-03 Impact factor: 3.454
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: Anne Brecht Francken; Helen M Shaw; John F Thompson; Seng-jaw Soong; Neil A Accortt; Manuela F Azzola; Richard A Scolyer; Gerald W Milton; William H McCarthy; Marjorie H Colman; Vincent J McGovern Journal: Ann Surg Oncol Date: 2004-03-15 Impact factor: 5.344
Authors: Andrea Maurichi; Rosalba Miceli; Tiziana Camerini; Luigi Mariani; Roberto Patuzzo; Roberta Ruggeri; Gianfranco Gallino; Elena Tolomio; Gabrina Tragni; Barbara Valeri; Andrea Anichini; Roberta Mortarini; Daniele Moglia; Giovanni Pellacani; Sara Bassoli; Caterina Longo; Pietro Quaglino; Nicola Pimpinelli; Lorenzo Borgognoni; Daniele Bergamaschi; Catherine Harwood; Odysseas Zoras; Mario Santinami Journal: J Clin Oncol Date: 2014-07-07 Impact factor: 44.544
Authors: A C de Waal; A S van Harten-Gerritsen; K K H Aben; L A L M Kiemeney; M M van Rossum; W A M Blokx Journal: Br J Dermatol Date: 2014-04 Impact factor: 9.302
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: Alessandra Buja; Andrea Bardin; Giovanni Damiani; Manuel Zorzi; Chiara De Toni; Riccardo Fusinato; Romina Spina; Antonella Vecchiato; Paolo Del Fiore; Simone Mocellin; Vincenzo Baldo; Massimo Rugge; Carlo Riccardo Rossi Journal: Front Oncol Date: 2021-11-16 Impact factor: 6.244