Sentinel Lymph Node Biopsy in Thick-Melanoma Patients (N=350): What is Its Prognostic Role?

Ribero, Simone; Osella‐Abate, Simona; Sanlorenzo, Martina; Balagna, Elena; Senetta, Rebecca; Fierro, Maria Teresa; Macripò, Giuseppe; Macrì, Luigia; Sapino, Anna; Quaglino, Pietro

doi:10.1245/s10434-014-4211-7

Cited by 74 publications

(54 citation statements)

References 31 publications

(46 reference statements)

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“…The prognosis of melanoma patients is dependent on clinical and pathological features including Breslow thickness, ulceration, SLN status, tumour mitotic rate, primary site, patient age, and sex [8,13,21,23] . Noteworthy, among the anatomic sites, the trunk is the one associated with the worse prognosis.…”

Section: Discussionmentioning

confidence: 99%

Multiple Lymph Node Basin Drainage in Trunk Melanoma Is Not Associated with Survival of Sentinel Lymph Node-Positive Patients

Ribero

Abate

Pasquali³

et al. 2017

Dermatology

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Objectives: This study was aimed at investigating the prognostic role of multiple lymph node basin drainage (MLBD) in patients with positive sentinel lymph node (SLN) biopsy. Background: MLBD is frequently observed in patients with trunk melanoma undergoing SLN. The prognostic value of MLBD in SLN-positive patients is still debated. Methods: Retrospective data from 312 trunk melanoma patients with positive SLN biopsy (1991-2012) at 6 Italian referral centres were gathered in a multicentre database. MLBD was defined at preoperative lymphoscintigraphy. Clinical and pathological data were analysed for their association with disease-free interval (DFI) and disease-specific (DSS) survival. Results: MLBD was identified in 34.6% of patients (108/312) and was significantly associated with >1 positive SLN (37 vs. 15.2%; p < 0.001) and with >1 positive lymph node (LN) after complete lymph node dissection (CLND) (50.9 vs. 34.8%; p = 0.033). No differences were observed according to drainage pattern in patients who had negative and positive non-SLN at CLND. MLBD was not associated with either DFI or DSS. Multivariate analyses showed that tumour thickness, ulceration, and number of metastatic LNs were associated with worse DFI and DSS, while regression confirmed its protective role in survival. Conclusion: In positive SLN patients, MLBD has no association with survival, which is mainly related to American Joint Committee on Cancer (AJCC) prognostic factors. Since the overall number of positive LNs drives the prognosis, the importance of a CLND in all the positive basins is confirmed.

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Section: Discussionmentioning

confidence: 99%

Multiple Lymph Node Basin Drainage in Trunk Melanoma Is Not Associated with Survival of Sentinel Lymph Node-Positive Patients

Ribero

Abate

Pasquali³

et al. 2017

Dermatology

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“…10 Using immunostaining for D2-40, Peterson et al found LVI in 23% of 74 invasive melanomas. 9 Our double staining for D2-40/MITF1 method showed the highest LVI detection rate to date (38%). Taken together, these findings confirm that LVI is underestimated by H&E alone, and that immunohistochemistry is an essential ancillary diagnostic tool for LVI.…”

Section: Detectionmentioning

confidence: 70%

“…1,11,17 Previously, we showed that OS and disease-specific survival durations were shorter for patients with LVI than for those without LVI, and that immunostaining-detected LVI and ulceration were associated significantly with OS. 9 Rose et al 11 found that immunostaining-detected LVI was a significant marker of both reduced DFS and OS. Xu et al 17 found that LVI was associated significantly with time to regional nodal metastatic disease, time to first metastasis, and melanomaspecific death.…”

Section: Survival Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic Implication of Lymphovascular Invasion Detected by Double Immunostaining for D2-40 and MITF1 in Primary Cutaneous Melanoma

Feldmeyer¹,

Tetzlaff²,

Fox

et al. 2016

The American Journal of Dermatopathology

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Background: Lymphovascular invasion (LVI) is associated with adverse outcomes in primary cutaneous melanoma (PCM). Detection of LVI by hematoxylin and eosin staining alone is 0%-6%, but targeting lymphovascular structures increases the detection rate.Objective: To examine the prognostic significance of LVI detected by immunostaining for D2-40 and microphthalmia-associated transcription factor 1 (MITF1) in PCM. Methods:The authors retrospectively analyzed 120 PCM samples.We compared the LVI detection rates of immunostaining for D2-40 only (22%), double staining for D2-40 and MITF1 (38%), and hematoxylin and eosin, and examined the association of LVI with clinicopathologic variables and clinical outcomes.Results: Immunolabeling with both methods significantly increased the LVI detection rate. Double staining for D2-40 and MITF1 as well as D2-40-detected LVI was significantly associated with increased Breslow thickness, number of mitoses, and sentinel lymph node (SLN) metastasis. D2-40-detected LVI was also associated with ulceration. Although the difference was not significant, double staining for D2-40 and MITF1 allowed for easier detection of LVI than D2-40 alone.Limitations: This study was conducted in a tertiary referral institution; therefore, a referral bias cannot be excluded. Conclusions: Immunolabeling increased detection of LVI inPCM. Because LVI is a positive predictive marker for SLN metastasis, the authors propose using anti-D2-40 and anti-MITF1 in the evaluation of LVI in patients with PCM with a certain risk of SLN metastasis.

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“…Melanoma patients with intermediate and thick tumours are offered a sentinel node biopsy to identify lymph node spread as this procedure has prognostic value stratifying patients in different risk categories [31,32,33]. Other parameters such as mitoses and ulceration are also helpful in thinner melanomas [34].…”

Section: What Is New In the Treatment Of Cutaneous Melanoma?mentioning

confidence: 99%

What Is New in Melanoma Genetics and Treatment?

et al. 2016

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New therapies for advanced melanoma have led to major advances, which, for the first time, showed improved survival for patients with this very challenging neoplasm. These new treatments are based on gene-targeted therapies or stimulation of immune responses. However, these treatments are not without challenges in terms of resistance and toxicity. Physicians should be aware of these side effects as prompt treatment may save lives. Melanoma genetics is also unravelling new genetic risk factors involving telomere genes as well as new gene pathways at the somatic level which may soon become therapeutic targets. It is also shedding new light onto the pathology of this tumour with links to neural diseases and longevity.

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Sentinel Lymph Node Biopsy in Thick-Melanoma Patients (N=350): What is Its Prognostic Role?

Cited by 74 publications

References 31 publications

Multiple Lymph Node Basin Drainage in Trunk Melanoma Is Not Associated with Survival of Sentinel Lymph Node-Positive Patients

Multiple Lymph Node Basin Drainage in Trunk Melanoma Is Not Associated with Survival of Sentinel Lymph Node-Positive Patients

Prognostic Implication of Lymphovascular Invasion Detected by Double Immunostaining for D2-40 and MITF1 in Primary Cutaneous Melanoma

What Is New in Melanoma Genetics and Treatment?

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