Long-term prognostic value of sentinel lymph node tumor burden in survival of melanoma patients

Vuoristo, Mikko; Muhonen, Timo; Koljonen, Virve; Juteau, Susanna; Hernberg, Micaela; Ilmonen, Suvi; Jahkola, Tiina

doi:10.1080/0284186x.2021.1892820

Cited by 3 publications

(3 citation statements)

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“…No metastatic deposits confined to a subscapular microanatomical location were associated with metastasis to NSLNs and 22% of metastatic deposits found at the remaining four sites were associated with NSLNs 11 . Several recent studies also have found that a subscapular location is associated with a more favourable outcome 8,15–17 . Therefore, the CAP template for cutaneous melanoma currently includes reporting of nodal site as either subcapsular, intramedullary or other 14 .…”

Section: Description Of Current Tumour Burden Evaluation Methodsmentioning

confidence: 99%

“…11 Several recent studies also have found that a subscapular location is associated with a more favourable outcome. 8,[15][16][17] Therefore, the CAP template for cutaneous melanoma currently includes reporting of nodal site as either subcapsular, intramedullary or other. 14 The NCCN guidelines also recommend recording location of metastatic deposits within the lymph node.…”

Section: T U M O U R O F P E N E T R a T I V E D E P T Hmentioning

confidence: 99%

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Sentinel lymph node assessment in melanoma: current state and future directions

2023

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Assessment of sentinel lymph node status is an important step in the evaluation of patients with melanoma for both prognosis and therapeutic management. Pathologists have an important role in this evaluation. The methodologies have varied over time, from the evaluation of dimensions of metastatic burden to determination of the location of the tumour deposits within the lymph node to precise cell counting. However, no single method of sentinel lymph node tumour burden measurement can currently be used as a sole independent predictor of prognosis. The management approach to sentinel lymph node‐positive patients has also evolved over time, with a more conservative approach recently recognised for selected cases. This review gives an overview of past and current status in the field with a glimpse into future directions based on prior experiences and clinical trials.

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Section: Description Of Current Tumour Burden Evaluation Methodsmentioning

confidence: 99%

Section: T U M O U R O F P E N E T R a T I V E D E P T Hmentioning

confidence: 99%

Sentinel lymph node assessment in melanoma: current state and future directions

2023

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“…9,10 Despite the clinical implications of a positive SLN biopsy, there is currently no standardized method of pathologically reporting SLN biopsies. 11,12 Multiple criteria have been developed in an attempt to more accurately characterize SLN metastatic burden, including the maximum diameter of the largest tumour deposit, [13][14][15][16][17][18][19] sum of maximum diameters of all tumour deposits, 20 the microanatomical location of the tumour deposits, 21 tumour penetrative depth, [22][23][24] area of tumour [25][26][27][28][29] and volume of tumour, 29 all of which have been shown to correlate with survival. The most commonly cited criteria include the Rotterdam (maximum diameter of largest tumour deposit), Dewar (microanatomical location) and Starz (tumour penetrative depth) classifications.…”

Section: Introductionmentioning

confidence: 99%

Sentinel lymph node tumour burden using digital cell count estimation predicts outcomes in melanoma

et al. 2022

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Background and aims Cutaneous melanoma often metastasises in primis to sentinel lymph nodes (SLNs). Currently, there is no standardized method of characterizing the micrometastatic tumour burden in SLN biopsies for melanoma. Different criteria have been developed to evaluate SLN biopsies, yet none consider the number of cells identified. Here, we used software analysis to digitally quantify metastatic tumour burden within SLNs and correlated these data with clinicopathological and prognostic information. Methods and results We identified 246 cases of SLN biopsies, including 63 positive (26%) and183 (74%) negative for metastatic melanoma. Digital cell counting was performed within the greatest metastatic focus and the entire metastatic tumour burden within the same SLN. Increasing cell count in the largest metastatic deposit correlated with the previously described Rotterdam [Spearman's r = 0.91; 95% confidence interval (CI) = 0.84, 0.94], Starz (Spearman's r = 0.78; 95% CI = 0.68, 0.87) and Dewar criteria (P < 0.01), validating our method of using cell count to define SLN tumour burden. Additionally, increasing cell count was associated with decreased metastasis‐free survival (hazard ratio = 2.29; 95% CI = 1.22, 4.31). Conclusion These data support the use of computerized cell count analysis for prognostication of outcomes in patients undergoing SLN biopsy.

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