Anatomic Region of Cutaneous Melanoma Impacts Survival and Clinical Outcomes: A Population-Based Analysis

Shannon, Christian M; Mehta, Neil K.; Li, Hong; Nguyen, Shaun A.; Koochakzadeh, Sina; Elston, Dirk M.; Kaczmar, John M.; Day, Terry A.

doi:10.3390/cancers15041229

Cited by 11 publications

(10 citation statements)

References 30 publications

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“…Regarding the prognostic value of the demographic characteristics, there are conflicting reports. Similar to our findings, the male gender has previously been linked with decreased survival by some authors [ 3 , 24 ], while others found no such association [ 25 , 26 ]. Interestingly, an advanced age was only associated with a decreased OS but not PFS, which may be explained by the fact that older patients could have higher mortality rates due to other comorbidities that were not accounted for [ 27 ].…”

Section: Discussionsupporting

confidence: 92%

The Prognostic Value of Proliferative Activity in Cutaneous Melanoma: A Pilot Study Evaluating the Mitotic Rate and Ki67 Index to Predict Patient Outcomes

Tapoi,

Gheorghișan-Gălățeanu,

Gosman

et al. 2024

Biomedicines

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Proliferative activity in cutaneous melanomas can be appreciated both histopathologically by counting mitotic figures and immunohistochemically through the Ki67 index, but the prognostic value of each method is still a matter of debate. In this context, we performed a retrospective study on 33 patients diagnosed with cutaneous melanomas between 2013 and 2018 in order to evaluate progression-free survival and overall survival. Multivariate Cox proportional hazards regression was performed by considering both clinical histopathological and immunohistochemical features. The mitotic rate was significantly independently associated with both outcomes, while the Ki67 index was not an independent prognostic factor. However, the Ki67 predictive accuracy could be improved by establishing both a cut-off value and a standardized protocol for evaluating its expression. Until these desiderata are met, the mitotic rate remains superior to the Ki67 index for predicting prognosis in cutaneous melanomas, as also has the advantage of being easily interpreted in a standard histopathological examination regardless of the pathologist’s experience and with no further financial expenses. Importantly, this is one of very few articles that has shown perineural invasion to be an independent prognostic factor for both progression-free survival and overall survival in cutaneous melanomas. As a consequence, this parameter should become a mandatory feature in the histopathological evaluation of cutaneous melanomas as it can improve the identification of patients who are at high risk for disease progression.

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Section: Discussionsupporting

confidence: 92%

The Prognostic Value of Proliferative Activity in Cutaneous Melanoma: A Pilot Study Evaluating the Mitotic Rate and Ki67 Index to Predict Patient Outcomes

Tapoi,

Gheorghișan-Gălățeanu,

Gosman

et al. 2024

Biomedicines

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“…Related to the gender distribution, the study emphasized the fact that the male gender predominates, with 58.1% of cases; this value being close to that obtained by an American trial based on a cohort of 178,000 cases from the period 2004-2014 where, in the case of melanomas located on the trunk, 66.1% were male patients [26]. Moreover, in our study, male gender was more frequent among subjects diagnosed with melanoma on the lower trunk than those with the upper location.…”

Section: Discussionsupporting

confidence: 81%

Variability of Sentinel Lymph Node Location in Patients with Trunk Melanoma

Bobirca,

Leventer,

Georgescu

et al. 2023

Diagnostics

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(1) Background: Melanoma is one of the most aggressive types of neoplasia, and the management of this pathology requires a correct staging, as well as a personalized modern oncological treatment. The main objective of the study is to determine the variability of the lymphatic drainage for patients with melanomas located on the trunk and, secondarily, to determine the features of individuals who underwent sentinel lymph node biopsy (SLNB) depending on the exact location on the trunk. (2) Methods: This retrospective, observational, single-center study included 62 cases of trunk melanoma operated between July 2019 and March 2023, in which SLNB was performed and a total of 84 lymph nodes were excised. (3) Results: Patients had a median age of 54.5 (33–78) years, with 58.1% being male; the melanomas had a median Breslow index of 2.3 (0.5–12.5) mm. Approximately 64.3% of the cohort had melanoma on the upper part of the trunk (54 cases) and 35.7% had it on the lower part (30 cases). The type of anesthesia chosen was general anesthesia in 53 cases and spinal anesthesia in 9 cases (85.5% vs. 14.5%, p < 0.001). The number of sentinel lymph nodes excised was 54 for melanomas located on the upper part of the trunk (8 cervical and 46 axillary) and 30 sentinel lymph nodes for melanomas of the lower part of the trunk (16 at the axillary level and 14 at the inguinal level). Out of the 54 LNs identified in patients with melanoma on the upper part of the trunk, 13 were positive, with a total of 12 positive lymph nodes (LNs) from the axillar basin, and only one from the cervical region. Additionally, the incidence of patients with a minimum of two identified sentinel lymph nodes was 32.2%, with a total of seven having LN involvement in two basins, and only one of these cases showed positivity for malignancy. (4) Conclusions: SLNBs were more frequent in the axillary region overall, and had more positive SLNs. Moreover, melanoma on the upper part of the trunk had a higher rate of positive SLNs compared to the lower part. Tumors located on the lower part of the truck had more positive SLNs in the axillary region than in the inguinal one.

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“…However, the H&N is a common location for BCCs 22 and melanomas 23 . Other studies with much larger cohorts from state or nation-wide cancer registries report up to 40% of BCCs 22 and approximately 20-30% of melanomas arising in the H&N 23,24 .…”

Section: Discussionmentioning

confidence: 98%

MORPHOMETRIC IMAGE ANALYSIS COMPARISON OF BASAL CELL CARCINOMAS & MELANOMAS OF THE HEAD & NECK VERSUS OTHER SITES

Hue,

Ekanayake,

Dehmeshki

et al. 2024

Preprint

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BackgroundManagement of skin cancers are heavily dependent on clinical diagnosis via dermoscopy. Dermoscopic morphology of basal cell carcinomas (BCC) and melanomas influence diagnosis and may be influenced by anatomic location.ObjectiveIn this study, we aimed to investigate the morphologic differences between anatomic sites of the head and neck (H&N) versus other body sites in basal cell carcinomas and melanomas.Patients and methodsThe publicly available HAM10000 dataset was used in this study. Morphometric image analysis of the BCCs (n=422) and melanomas (n=868) in this dataset was performed using an open-source image analysis software. Univariate and multivariate statistical analysis was done to identify differences between H&N and other anatomic sites. The multifactorial data was further interrogated with dimensionality reduction techniques, linear discriminant analysis, principal component analysis and t-distributed stochastic neighbour embedding.ResultsUnivariate and multivariate statistical analyses revealed significant differences between H&N and other sites for both BCCs and melanomas (P<0.05). Fifty-three univariate and 11 multivariate features were found to be statistically significant in the BCC group. Thirteen univariate and 8 multivariate features were statistically significant in the melanoma group. Dimensionality reduction via linear discriminant analysis of the BCC groups revealed modest separation of the data by anatomical site. However, melanomas appeared to be more homogenous across H&N and other body sites.ConclusionBCCs of the H&N may be morphologically different to BCCs of other body sites. This may influence the accuracy of computer-assisted diagnostic tools and specialist clinicians working predominantly in the H&N region should exercise caution when employing these tools in clinical practice.

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Anatomic Region of Cutaneous Melanoma Impacts Survival and Clinical Outcomes: A Population-Based Analysis

Cited by 11 publications

References 30 publications

The Prognostic Value of Proliferative Activity in Cutaneous Melanoma: A Pilot Study Evaluating the Mitotic Rate and Ki67 Index to Predict Patient Outcomes

The Prognostic Value of Proliferative Activity in Cutaneous Melanoma: A Pilot Study Evaluating the Mitotic Rate and Ki67 Index to Predict Patient Outcomes

Variability of Sentinel Lymph Node Location in Patients with Trunk Melanoma

MORPHOMETRIC IMAGE ANALYSIS COMPARISON OF BASAL CELL CARCINOMAS & MELANOMAS OF THE HEAD & NECK VERSUS OTHER SITES

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