Prognostic heterogeneity after the excision of lymph node metastases in patients with cutaneous melanoma

Pilko, Gasper; Bešič, Nikola; Žgajnar, Janez; Hočevar, Marko

doi:10.1016/j.suronc.2009.09.004

Cited by 5 publications

(6 citation statements)

References 25 publications

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“…42,43 There is a subgroup of patients with better long-term survival, even when known adverse pathological risk factors such as macrometastasis, number of lymph node metastases and ulceration are taken into consideration. In particular, patients with stage III melanoma have a variable prognosis with reported 5-year survival rates of 23-87% depending on the substage.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, patients with stage III melanoma have a variable prognosis with reported 5-year survival rates of 23-87% depending on the substage. 42,43 There is a subgroup of patients with better long-term survival, even when known adverse pathological risk factors such as macrometastasis, number of lymph node metastases and ulceration are taken into consideration. Therefore, identification of a molecular marker will be useful for predicting subgroups of patients with prognostic benefits of adjuvant treatments in stage III melanoma.…”

Section: (B)mentioning

confidence: 99%

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Lack of XAGE‐1b and NY‐ESO‐1 in metastatic lymph nodes may predict the potential survival of stage III melanoma patients

Mori

Funakoshi

Kameyama

et al. 2017

The Journal of Dermatology

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The cancer-testis antigens (CTA) are a large family of tumor-associated antigens expressed by a variety of cancer cells and primitive germ cells of the adult testis and placenta. These tumor-restricted expressing patterns suggest that CTA would be ideal targets for tumor-specific immunotherapy. XAGE-1 is a CTA that was originally identified by computer-based screening, and four transcription variants, XAGE-1a, -1b, -1c and -1d, have been characterized to date. Although the presence of XAGE-1 transcripts has been reported in various cancers, the expression of XAGE-1b in melanoma has not been fully characterized. In this study, we performed immunohistochemical staining of XAGE-1b together with NY-ESO-1, a well-known CTA, in 113 melanoma samples obtained from 84 patients and evaluated their expression in tumor cells. The effects of expression on tumor progression and patient prognosis were analyzed. Both XAGE-1b and NY-ESO-1 were expressed at high levels in lymph node metastasis and skin metastasis samples compared with the primary site (P < 0.01 in XAGE-1b and P < 0.05 in NY-ESO-1). In a subgroup analysis of 22 patients with stage III lymph node metastasis, overall survival was significantly higher in the XAGE-1b and NY-ESO-1 double-negative group than in the other groups (P < 0.05). These results suggest that lack of XAGE-1b and NY-ESO-1 expression could have a positive influence on clinical outcome in patients with melanoma.

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Section: Discussionmentioning

confidence: 99%

Section: (B)mentioning

confidence: 99%

Lack of XAGE‐1b and NY‐ESO‐1 in metastatic lymph nodes may predict the potential survival of stage III melanoma patients

Mori

Funakoshi

Kameyama

et al. 2017

The Journal of Dermatology

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“…The known favorable prognostic factors in stage III cutaneous melanoma (CMM) according to the AJCC classification, including micrometastasis, low number of lymph node metastases, and no ulceration of the primary tumor, are insufficient to accurately predict clinical outcome [ 1 , 2 ]. There is thus a need for additional prognostic markers to more reliably determine the risk for progressing from regionally advanced CMM (stage III) to disseminated CMM (stage IV).…”

Section: Introductionmentioning

confidence: 99%

Presence of immune cells, low tumor proliferation and wild type BRAF mutation status is associated with a favourable clinical outcome in stage III cutaneous melanoma

et al. 2017

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BackgroundThe variable prognosis in stage III cutaneous melanoma is partially due to unknown prognostic factors. Improved prognostic tools are required to define patients with an increased risk of developing metastatic disease who might benefit from adjuvant therapies. The aim was to examine if cellular immune markers in association with tumor proliferation rate and BRAF mutation status have an impact on prognosis in stage III melanoma.MethodsWe have used two sets of case series with stage III disease: 23 patients with short survival (≤ 13 months) and 19 patients with long survival (≥ 60 months). Lymph node metastases were analyzed for Ki67, CD8 and FOXP3 protein expression using immunohistochemistry. BRAF mutation status was analyzed in a previous study on the same samples.ResultsLow tumor proliferation rate was significantly associated with a better prognosis (p = 0.013). Presence of FOXP3+ T cells was not correlated to adverse clinical outcome. A highly significant trend for a longer survival was found in the presence of an increasing number of markers; CD8+ and FOXP3+ T cells, low tumor proliferation and BRAF wildtype status (p = 0.003). Presence of at least three of these four markers was found to be an independent favorable prognostic factor (OR 19.4, 95% CI 1.9-197, p = 0.012), when adjusting for ulceration and number of lymph node metastases. Proliferation alone remained significant in multivariate analyses (OR 26.1, 95% CI 2.0-344, p = 0.013) but with a wider confidence interval. This panel still remained independent when also adjusting for a previously identified prognostic glycolytic-pigment panel.ConclusionsWe have demonstrated that presence of immune cells in association with tumor proliferation and BRAF mutation status may further contribute to identify stage III melanoma patients with high risk of relapse.

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“…Axillary lymph node dissection is a standard surgical procedure in case of positive lymph nodes in breast cancer or melanoma 19–21. Unfortunately, it can cause long-term morbidities: chronic postoperative pain, limited shoulder movement and/or lymphoedema 5,6.…”

Section: Discussionmentioning

confidence: 99%

Comparison of continuous local anaesthetic and systemic pain treatment after axillary lymphadenectomy in breast carcinoma patients – a prospective randomized study

Strazisar

Bešič²

2013

Radiology and Oncology

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BackgroundAcute pain after axillary lymphadenectomy is often related mainly to axillary surgery. The aim of the prospective randomized study was to find out if continuous wound infusion of local anaesthetic reduces postoperative pain, consumption of opioids and the incidence of chronic pain compared to the standard intravenous piritramide analgesia after axillary lymphadenectomy in breast carcinoma patients.MethodsAltogether 60 patients were enrolled in the prospective randomized study; half in wound infusion of local anaesthetic and half in the standard (piritramide) group.ResultsIn the recovery room and on the first day after surgical procedure, the wound infusion of local anaesthetic group reported less acute and chronic pain, a lower consumption of piritramide and metoclopramide, but their alertness after the surgical procedure was higher compared to the standard group.ConclusionsAfter axillary lymphadenectomy in breast carcinoma patients, wound infusion of local anaesthetic reduces acute pain and enables reduced opioid consumption, resulting in less postoperative sedation and a reduced need for antiemetic drugs. After wound infusion of local anaesthetic there is a statistical trend for reduction of chronic pain.

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Prognostic heterogeneity after the excision of lymph node metastases in patients with cutaneous melanoma

Cited by 5 publications

References 25 publications

Lack of XAGE‐1b and NY‐ESO‐1 in metastatic lymph nodes may predict the potential survival of stage III melanoma patients

Lack of XAGE‐1b and NY‐ESO‐1 in metastatic lymph nodes may predict the potential survival of stage III melanoma patients

Presence of immune cells, low tumor proliferation and wild type BRAF mutation status is associated with a favourable clinical outcome in stage III cutaneous melanoma

Comparison of continuous local anaesthetic and systemic pain treatment after axillary lymphadenectomy in breast carcinoma patients – a prospective randomized study

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