Desmoplastic and desmoplastic neurotropic melanoma

Quinn, Michael; Crotty, Kerry A.; Thompson, John F.; Coates, Alan S.; O’Brien, Christopher J.; McCarthy, William H.

doi:10.1002/(sici)1097-0142(19980915)83:6<1128::aid-cncr11>3.3.co;2-y

Cited by 74 publications

(188 citation statements)

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“…[21][22][23] Although desmoplastic melanoma was first characterized in the medical literature in 1971, 2 only recently (2004) has the concept of two morphological subtypes been put forth. 20 Owing to the rarity of desmoplastic melanomas in general and this nascent classification system, the relative incidence of the two subtypes is not well established.…”

Section: Discussionmentioning

confidence: 99%

Mixed versus pure variants of desmoplastic melanoma: a genetic and immunohistochemical appraisal

et al. 2012

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Desmoplastic melanoma is subclassified into pure and mixed variants with a higher rate of lymph node metastasis in the latter. Given that reasons for these biological differences are not currently known, we investigated these subtypes with techniques that included genetic and immunohistochemical analyses of 43 cases of desmoplastic melanoma (24 pure, 19 mixed). Direct DNA sequencing was performed on BRAFV600E, RET gene (coding region on exon 11) and KIT (exons 11, 13 and 17). Immunohistochemical stains were performed with antibodies to markers of significance with respect to biological potential of nevomelanocytic proliferations and/or desmoplastic melanoma (Ki-67, CD117, nestin, clusterin, SOX10 and CD271/p75NTR). Polymorphism at the RET coding region (RETp) was noted in 33% of pure (8/24 cases) versus 24% of mixed (4/17 cases); BRAFV600E was absent in all cases of pure (0/24 cases) versus 6% of mixed (1/17 cases); no mutations were found in any of the cases on analyses of exons 11, 13 and 17 of the c-KIT gene (P ¼ NS for all). For immunohistochemical analyses of pure versus mixed: mean percentage of Ki-67 nuclear positivity was 5% (s.d. ¼ 5.6) versus 28% (s.d. ¼ 12.6, Po0.001); CD117 stained 26% (6/23 cases) versus 78% (14/18 cases, Po0.01); nestin stained 83% (n ¼ 19/23 cases) versus 89% (16/18 cases, P ¼ NS); clusterin stained 4% (1/23 cases) versus 6% (1/18 cases, P ¼ NS); SOX10 87% (20/23 cases) versus 94% (17/18 cases, P ¼ NS) and CD271 stained 61% (14/23 cases) versus 67% (12/18 cases, P ¼ NS). Increased CD117 staining in the mixed variant suggests that alterations in the KIT protein may be involved in tumor progression. In addition, the proliferative index of the mixed variant was higher than that of the pure variant.

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Section: Discussionmentioning

confidence: 99%

Mixed versus pure variants of desmoplastic melanoma: a genetic and immunohistochemical appraisal

et al. 2012

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“…Of the 9% of patients diagnosed with desmoplastic melanoma (n ϭ 28), 96% (n ϭ 27) had neurotropism. Even though the presence of neurotropism has been believed to be a risk factor for early recurrence, 16 the 5-year OS rate in the desmoplastic neurotropic subgroup was 70%. The median OS had not been reached in the desmoplastic neurotropic subgroup at the time of last follow-up, but it exceeded 6.0 years.…”

Section: Tumor Typementioning

confidence: 99%

Prognostic factors in patients with thick cutaneous melanoma (> 4 mm)

Zettersten

Sagebiel

Miller

et al. 2002

Cancer

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BACKGROUNDThe current study was conducted to examine the role of multiple clinical and histologic factors in the prognostic assessment of patients with thick primary melanoma (> 4 mm, classified as T4).METHODSA retrospective analysis was performed in 329 patients with T4 cutaneous melanomas who were seen at the University of California at San Francisco Melanoma Center between 1978 and 2000. Fourteen histopathologic features were recorded prospectively by a single dermatopathologist. In addition, 9 clinical factors were analyzed.RESULTSSeveral histologic factors were found to have a significant impact on the survival of patients with T4 melanoma. On univariate analysis, tumor thickness, ulceration, mitotic rate, microsatellites, vascular involvement, and histogenetic type of the primary tumor all were found to have a significant impact on the overall survival rate. Regional lymph node involvement reduced the overall survival of T4 patients dramatically. The 5‐year overall survival of patients with lymph node‐negative T4 disease was 61%, compared with 30% for those with lymph node‐positive disease. When lymph node status was taken into account, tumor thickness, vascular involvement, and ulceration all remained independent predictors of overall survival on multivariate Cox regression analysis. Neither age, gender, nor anatomic location appeared to affect the recurrence‐free or overall survival rates.CONCLUSIONSPatients with thick primary cutaneous melanomas (> 4 mm) comprise a heterogeneous group. The presence or absence of lymph node involvement, vascular involvement, and ulceration appears to result in significantly divergent overall survival rates in this patient cohort. Consideration of these factors has important implications in the management of patients with T4 melanoma. Cancer 2002;94:1049–56. © 2002 American Cancer Society.DOI 10.1002/cncr.10326

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“…1. It is more common in males and the most common sites of involvement are sun‐exposed skin surfaces of the head and neck, followed by the extremities and trunk 2, 3, 4. These lesions can often be difficult to differentiate from other benign and malignant neoplasms, potentially leading to inaccurate diagnosis and inadequate treatment 5, 6.…”

Section: Introductionmentioning

confidence: 99%

“…These lesions can often be difficult to differentiate from other benign and malignant neoplasms, potentially leading to inaccurate diagnosis and inadequate treatment 5, 6. Historical local recurrence rates (LRRs) for patients with DM are in the range of 20–50% 2, 3, 4, 5, 7, 8, though recent series have suggested potentially lower rates in selected patients (negative margins, non‐head and neck location, lack of perineural invasion, decreasing Breslow depth, etc.) 9, 10, 11, 12.…”

Section: Introductionmentioning

confidence: 99%

Results of NCCTG N0275 (Alliance) – a phase II trial evaluating resection followed by adjuvant radiation therapy for patients with desmoplastic melanoma

et al. 2016

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To examine, in a prospective fashion, the utilization and efficacy of adjuvant radiation therapy (RT) in patients with resected desmoplastic melanoma (DM). Adult patients with resected, margin‐negative, and nonmetastatic DM were eligible for this single‐arm prospective phase II study. Patients were to receive postoperative RT, 30 Gy in five fractions, to the operative bed with 2‐ to 3‐cm margins (depending on the tumor location). Nodal basin RT was not allowed. The primary study endpoint was the 2‐year local recurrence rate (LRR). Secondary endpoints included the incidence of regional and distant metastatic disease, progression‐free survival, overall survival (OS), and treatment‐related toxicity. Twenty patients with a single de novo DM lesion meeting trial eligibility criteria were enrolled and treated. The 2‐year LRR was 10%, with two patients demonstrating a LR within 2 years of completion of protocol therapy. No regional or distant failures occurred. OS at 2 and 5 years was 95 and 77%, respectively. There were no grade 3 or higher acute or late adverse events that were related to the protocol therapy. Adjuvant RT after wide local excision (WLE) for DM is efficacious and well tolerated. It should be considered for DM patients after margin‐negative WLE. Additional study is needed to further refine low‐risk patient populations that can potentially have adjuvant RT omitted as part of the treatment plan.

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Desmoplastic and desmoplastic neurotropic melanoma

Cited by 74 publications

References 0 publications

Mixed versus pure variants of desmoplastic melanoma: a genetic and immunohistochemical appraisal

Mixed versus pure variants of desmoplastic melanoma: a genetic and immunohistochemical appraisal

Prognostic factors in patients with thick cutaneous melanoma (> 4 mm)

Results of NCCTG N0275 (Alliance) – a phase II trial evaluating resection followed by adjuvant radiation therapy for patients with desmoplastic melanoma

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