Prognosticators of melanoma, the melanoma report, and the sentinel lymph node

Crowson, A. Neil; Magro, Cynthia M.; Mihm, Martín C.

doi:10.1038/modpathol.3800517

Cited by 73 publications

(50 citation statements)

References 100 publications

(110 reference statements)

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“…Staging is performed according to the tumor, node, metastasis staging system, with tumor depth (Breslow depth) showing the most significant predictor of lymph node metastasis and overall survival. 38,39 For in-situ melanomas, cryotherapy and laser therapy both show overall higher rates of recurrence compared with surgical excision. Radiotherapy demonstrates recurrence rates as low as 7 percent.…”

Section: Melanomamentioning

confidence: 98%

Hand Tumors

Henderson¹,

Neumeister²,

Bueno³

2014

Plastic and Reconstructive Surgery

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Hand tumors of the skin and soft tissue are frequently encountered by plastic surgeons. Although similar to lesions affecting other parts of the body, the presentation, workup, and treatment options often differ in the hand secondary to its complex anatomy and functional significance. The purpose of this article is to provide an overview of those lesions that commonly arise in the hand-including epidermal inclusion cysts, ganglion cysts, and glomus tumors-in addition to tumors such as soft-tissue sarcomas that are rare but nonetheless require astute diagnosis and expedient initiation of treatment. Presenting symptoms and clinical features, recommended workup, and appropriate treatment options are reviewed.

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Section: Melanomamentioning

confidence: 98%

Hand Tumors

Henderson¹,

Neumeister²,

Bueno³

2014

Plastic and Reconstructive Surgery

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“…Within Australia and internationally, synoptic report templates for melanoma have been developed and recommended [5, 10,21,22,23,24]. Free text reporting is prone to ambiguities (i.e.…”

Section: Discussionmentioning

confidence: 99%

Completeness of Histopathology Reporting of Melanoma in a High-Incidence Geographical Region

et al. 2008

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Background: Appropriate histopathology reporting helps to ensure effective therapy and prognosis. Objective: Toexamine compliance with clinical practice guidelines for histopathology reports of melanomas. Methods: A sample of melanoma histopathology reports in Queensland was audited for inclusion of recommended information. The quality of documentation was constructed and multivariate analysis used to determine factors affecting the quality of reporting practices. Results: Documentation of the most important features of melanoma was high: clear diagnosis (99.8%; 95% CI 98.6–100), thickness (99.8%; 95% CI 98.6–100), comment on adequacy of excision (87.9%; 95% CI 84.9–91.0) and measurement of margins (91.9%; 95% CI 88.8–91.4). Overall reporting of ulceration and regression was of lesser completeness (83.0 and 77.8%, respectively) and these features were more likely to be reported by high-volume laboratories (p < 0.001 and p = 0.037, respectively). This trend was not apparent for other features. Fewer than 50% of reports documented mitotic rate per square millimetre, predominant cell type, microsatellites, growth phase and desmoplasia. Conclusion: Awareness of current reporting practices and identification of areas in which insufficiencies exist enable the revision of systems and potential improvements to the transfer of information to treating clinicians.

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“…16 However, some authors differentiate complete from generalized regression as the total absence of melanocytes in epidermis and dermis, even if it is only an area in an otherwise intact melanoma. 79 At our institution, we do not routinely report the active/ early stage of regression (Figure 1a), due to the considerable overlap between TILs and early stage regression. We define histologic regression as the presence of an area of mononuclear cell infiltrate with associated variable loss of melanoma cells, varying degrees of non-laminated dermal fibrosis, melanophagocytosis, and telangiectatic blood vessels; and variably attenuated epidermis (Figure 1b).…”

Section: Heterogeneity In the Definition Of Histologic Regressionmentioning

confidence: 99%

Regression in primary cutaneous melanoma: etiopathogenesis and clinical significance

Aung

Nagarajan

Prieto

2017

Laboratory Investigation

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Though not required currently for staging, regression is a histopathologic parameter typically reported upon diagnosis of an invasive primary cutaneous melanoma. The studies examining the prognostic significance of regression in patient outcome have yielded controversial findings; likely because the definition and assessment of regression have not been consistent, in addition to subjectivity of pathologists' interpretation. Regression is histologically characterized by variable decrease in the number of melanoma cells accompanied by the presence of a host response consisting of dermal fibrosis, inflammatory infiltrate, melanophages, ectatic blood vessels, epidermal attenuation, and/or apoptosis of keratinocytes or melanocytes; the relative extent of these features depends on the stage of the regression. However, the magnitudes to which these individual changes must be present to meet the threshold of histologic regression have not been well defined or agreed upon, and thus, the definition and classification of histologic regression in melanoma varies considerably among institutions and even among individual pathologists. In order to determine the clinical significance of histologic analysis of regression, there is a compelling need for a universal scheme to objectively define and assess histologic regression in primary cutaneous melanoma, so that the biologic and prognostic significance of this process may be completely understood.

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Prognosticators of melanoma, the melanoma report, and the sentinel lymph node

Cited by 73 publications

References 100 publications

Hand Tumors

Hand Tumors

Completeness of Histopathology Reporting of Melanoma in a High-Incidence Geographical Region

Regression in primary cutaneous melanoma: etiopathogenesis and clinical significance

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