Mitotic rate as an important prognostic factor in cutaneous malignant melanoma

Piñero-Madrona, Antonio; Ruíz-Merino, Guadalupe; Fuentes, Pablo; Martínez‐Barba, Enrique; Rodrı́guez-López, José Neptuno; Cabezas-Herrera, Juan

doi:10.1007/s12094-019-02064-4

Cited by 23 publications

(22 citation statements)

References 29 publications

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“…H-BRAF V600E patients had statistically lower Breslow and mitotic indexes than L-BRAF V600E (Mean 2.617 ± 0.4426 vs. 5.280 ± 0.8373 and Mean 2.571 ± 0.5714 vs. 6.000 ± 1.202). These results indicated that the H-BRAF V600E MMp had better prognostic features than the L-BRAF V600E since their Breslow tended to be <4 mm and they had a lower mitotic index [1,20,22] (Figure 3B,C). No statistical differences were observed regarding age and gender, MMp subtype, Clark or ulceration.…”

Section: H-braf V600e Correlation With Demographic Clinical and Tumor Characteristicsmentioning

confidence: 86%

“…Besides the usefulness of the BRAF V600E driver mutation as a therapeutic target, a recent study has suggested that the mutational load of BRAF V600E is a possible prognostic biomarker [15], expanding the classical histopathological prognostic criteria such as ulceration, Breslow, Clark or mitotic indexes [1,[16][17][18][19][20][21][22]. Moreover, some studies in recent years have attempted to relate the mutational load to the response in order to target therapies, but controversial results have been obtained [23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

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BRAFV600E Mutant Allele Frequency (MAF) Influences Melanoma Clinicopathologic Characteristics

Gili

Vilardell

Maiques

et al. 2021

Cancers

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Background: Cutaneous melanoma shows high variability regarding clinicopathological presentation, evolution and prognosis. Methods: Next generation sequencing was performed to analyze hotspot mutations in different areas of primary melanomas (MMp) and their paired metastases. Clinicopathological features were evaluated depending on the degree of variation of the BRAFV600E mutant allele frequency (MAF) in MMp. Results: In our cohort of 14 superficial spreading, 10 nodular melanomas and 52 metastases, 17/24 (71%) melanomas had a BRAFV600E mutation and 5/24 (21%) had a NRASQ61 mutation. We observed a high variation of BRAFV600E MAF (H-BRAFV600E) in 7/17 (41%) MMp. The H-BRAFV600E MMp were all located on the trunk, had lower Breslow and mitotic indexes and predominantly, a first nodal metastasis. Regions with spindled tumor cells (Spin) and high lymphocytic infiltrate (HInf) were more frequent in the H-BRAFV600E patients (4/7; 57%), whereas regions with epithelial tumor cells (Epit) and low lymphocytic infiltrate (LInf) were predominant (6/10; 60%) and exclusive in the low BRAFV600E MAF variation tumors (L-BRAFV600E). The H-BRAFV600E/Spin/HInf MMp patients had better prognostic features and nodal first metastasis. Conclusions: The H-BRAFV600E MMp were located on the trunk, had better prognostic characteristics, such as lower Breslow and mitotic indexes as well as high lymphocytic infiltrate.

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Section: H-braf V600e Correlation With Demographic Clinical and Tumor Characteristicsmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

BRAFV600E Mutant Allele Frequency (MAF) Influences Melanoma Clinicopathologic Characteristics

Gili

Vilardell

Maiques

et al. 2021

Cancers

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“…It is interesting that the detection of mitotic figures increased when freshly stained slides were substituted for slides that had faded during our study; this indicates the importance of optimal histology. Published evidence that MR is well established as a key prognostic factor 25,26 and marker of tumor proliferation in melanoma signifies that the continued reporting of MR by pathologists is of great importance even though its removal as a staging criterion from the AJCC's eighth edition has brought about more reliable and reproducible staging. However, the removal of MR potentially could result in a failure to capture an important subset of cases that may require additional monitoring.…”

Section: Discussionmentioning

confidence: 99%

Histopathologic synoptic reporting of invasive melanoma: How reliable are the data?

Taylor

Eguchi

Reisch

et al. 2021

Cancer

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Background Synoptic reporting is recommended by many guideline committees to encourage the thorough histologic documentation necessary for optimal management of patients with melanoma. Methods One hundred fifty‐one pathologists from 40 US states interpreted 41 invasive melanoma cases. For each synoptic reporting factor, the authors identified cases with “complete agreement” (all participants recorded the same value) versus any disagreement. Pairwise agreement was calculated for each case as the proportion of pairs of responses that agreed, where paired responses were generated by the comparison of each reviewer's response with all others. Results There was complete agreement among all reviewers for 22 of the 41 cases (54%) on Breslow thickness dichotomized at 0.8 mm, with pairwise agreement ranging from 49% to 100% across the 41 cases. There was complete agreement for “no ulceration” in 24 of the 41 cases (59%), with pairwise agreement ranging from 42% to 100%. Tumor transected at base had complete agreement for 26 of the 41 cases (63%), with pairwise agreement ranging from 31% to 100%. Mitotic rate, categorized as 0/mm2, 1/mm2, or 2/mm2, had complete agreement for 17 of the 41 cases (41%), with pairwise agreement ranging from 36% to 100%. Regression saw complete agreement for 14 of 41 cases (34%), with pairwise agreement ranging from 40% to 100%. Lymphovascular invasion, perineural invasion, and microscopic satellites were rarely reported as present. Respectively, these prognostic factors had complete agreement for 32 (78%), 37 (90%), and 18 (44%) of the 41 cases, and the ranges of pairwise agreement were 47% to 100%, 70% to 100%, and 53% to 100%, respectively. Conclusions These findings alert pathologists and clinicians to the problem of interobserver variability in recording critical prognostic factors. Lay Summary This study addresses variability in the assessment and reporting of critical characteristics of invasive melanomas that are used by clinicians to guide patient care. The authors characterize the diagnostic variability among pathologists and their reporting methods in light of recently updated national guidelines. Results demonstrate considerable variability in the diagnostic reporting of melanoma with regard to the following: Breslow thickness, mitotic rate, ulceration, regression, and microscopic satellites. This work serves to alert pathologists and clinicians to the existence of variability in reporting these prognostic factors.

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“…The presence of mitoses, as well as tumor thickness and distant metastases, was considered a strong prognostic factor for CM. 24 , 25 , 26 The seventh edition of AJCC recommended that the mitotic rate be used as a prognostic variable to stratify the T‐category in T1 melanoma. 27 However, recent results on prognostic value of the mitotic rate have been controversial.…”

Section: Discussionmentioning

confidence: 99%

Genetic variants of SDCCAG8 and MAGI2 in mitosis‐related pathway genes are independent predictors of cutaneous melanoma‐specific survival

Liu

Luo

et al. 2021

Cancer Science

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Mitotic rate as an important prognostic factor in cutaneous malignant melanoma

Cited by 23 publications

References 29 publications

BRAFV600E Mutant Allele Frequency (MAF) Influences Melanoma Clinicopathologic Characteristics

BRAFV600E Mutant Allele Frequency (MAF) Influences Melanoma Clinicopathologic Characteristics

Histopathologic synoptic reporting of invasive melanoma: How reliable are the data?

Genetic variants of SDCCAG8 and MAGI2 in mitosis‐related pathway genes are independent predictors of cutaneous melanoma‐specific survival

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