The Prognostic Importance of Tumor Mitotic Rate Confirmed in 1317 Patients With Primary Cutaneous Melanoma and Long Follow-Up

Francken, Anne Brecht; Shaw, Helen M.; Thompson, John F.; Soong, Seng‐Jaw; Accortt, Neil A.; Azzola, Manuela F.; Scolyer, Richard A.; Milton, G. W.; McCarthy, William H.; Colman, Marjorie H.; McGovern, V. J.

doi:10.1245/aso.2004.07.014

Cited by 183 publications

(126 citation statements)

References 26 publications

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“…2 Unfortunately, we had no data regarding the mitotic rate of primary tumor, which was recently shown to be an independent prognostic variable in CM patients. 34 In addition, the sentinel lymph node status of our patients diagnosed during the early years of the study was not available, and for this reason we included all patients without clinical evidence of metastasis. Although SLNB significantly prolongs DFS, so far there is no evidence that this procedure has an impact on the DSS of patients with melanoma.…”

Section: Discussionmentioning

confidence: 99%

Age and gender are significant independent predictors of survival in primary cutaneous melanoma

Lasithiotakis¹,

Leiter²,

Meier³

et al. 2008

Cancer

228

178

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BACKGROUNDThe aim was to identify age‐ related and gender‐related differences in the clinical presentation and outcome of patients with primary cutaneous melanoma (CM).METHODSA total of 4785 CM patients without clinical evidence of metastasis diagnosed during the period 1976–2001 in southern Germany included in the analysis. Kaplan‐Meier analyses were performed to estimate and to compare disease‐specific survival (DSS) and survival after first recurrence (SAR). The Cox proportional hazards model was used to evaluate the effect of multiple variables on DSS and SAR.RESULTSIncreasing age and male gender were independently associated with thicker tumors (>2 mm) and histologic ulceration (P < .001). Patients older than 65 years had lower 10‐year DSS than younger patients (81.8% vs 88.4%, P < .001) and this difference was more pronounced in women (P < .001) than in men (P = .06). Males had lower 10‐year DSS than females (83.5% vs 88.5%, P < .001) but this difference did not reach statistical significance in patients older than 65 years (P = .162). In multivariate analysis adjusted for tumor thickness, ulceration, anatomic site, histologic subtype, DSS, site of first recurrence, time trend, sentinel lymph node status, age, and gender were independent predictors of DSS and SAR (P < .05).CONCLUSIONSOlder age and male gender are associated with prognostically unfavorable primary CM. Expansion of current preventive strategies to target these subgroups is warranted. Moreover, age and gender are independent predictors of the outcome of CM patients. Females have a better prognosis than males but this difference disappears after the age of 65. Younger patients have a more favorable prognosis than older patients, a difference more pronounced in women. Cancer 2008. © 2008 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Age and gender are significant independent predictors of survival in primary cutaneous melanoma

Lasithiotakis¹,

Leiter²,

Meier³

et al. 2008

Cancer

228

178

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“…23 The mitotic rate (defined as mitoses/mm 2 ) of the primary tumor can serve as a measure for tumor proliferation and has been identified as an independent, adverse predictor of survival in patients with cutaneous melanoma. 24,25 The seventh edition of the American Joint Committee on Cancer (AJCC) staging system for melanoma now uses a mitotic rate of at least 1 mitosis/mm 2 as a primary criterion for defining stage T1b melanoma, replacing the former criterion of Clark level of invasion, because studies have demonstrated that an increasing mitotic rate is associated with declining survival rates, particularly within thin melanoma subgroups. 25,26 In the current study, we sought to determine whether or not there is a biologic difference in SPM and MPM to explain the observation that patients with MPM have thinner melanomas and a better prognosis than patients with SPM.…”

Section: Introductionmentioning

confidence: 99%

Single versus multiple primary melanomas

Hwa

Price

Belitskaya-Lévy

et al. 2012

Cancer

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BACKGROUND:In patients with multiple primary melanomas (MPM), mean tumor thickness tends to decrease from the first melanoma to the second melanoma, and prognosis may be improved compared with the prognosis for patients who have a single primary melanoma (SPM). In this study, the authors compared the clinicopathologic features of patients with MPM and SPM to better characterize the differences between these 2 groups and to determine whether or not there is an inherent difference in tumor aggression. METHODS: In total, 788 patients with melanoma who were enrolled prospectively in the Interdisciplinary Melanoma Cooperative Group database from 2002 to 2008 were studied. Patients with SPM and with MPM were compared with regard to clinical and primary melanoma characteristics. RESULTS: Of 788 patients with melanoma, 61 patients (7.7%) had 2 or more primary melanomas. The incidence of developing a second primary melanoma 1 year and 5 years after initial melanoma diagnosis was 4.1% and 8.7%, respectively, and most of the risk accumulated within the first year. The incidence of MPM was greater in patients aged !60 years than in those aged 60 years. The absence or presence of mitosis and other tumor characteristics did not differ significantly between patients with SPM and patients with MPM (P ¼ .61). CONCLUSIONS: No difference was observed in the presence or absence of mitoses, a marker of tumor proliferation, in SPM and MPM. Because it has been demonstrated that the presence of mitosis is a powerful prognostic marker, the current findings suggested that the tumors behave similarly in patients with SPM and patients with MPM. The authors concluded that differences in tumor thickness and prognosis between SPM and MPM more likely are caused by factors other than tumor biology, such as increased surveillance. Cancer 2012;118:4184-92.

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“…Barnhill et al compared the values of MR vs. ulceration in predicting the prognosis of localized melanoma; multivariate analysis of MR, ulceration, and tumor thickness showed that MR (<1, 1−6, and >6) is the most independent prognostic factor. In addition, some other studies also confirmed that MR is an important prognostic factor of skin melanoma (25)(26)(27)(28). According to the AJCC staging system (2010 edition), patients with an MR value of ≥1 is an independent prognostic factor of poor prognosis, in particular in patients with an infiltration thickness of ≤1 mm.…”

Section: Pathology Reportmentioning

confidence: 84%

Chinese Guidelines on the Diagnosis and Treatment of Melanoma (2015 Edition)

et al. 2016

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The Prognostic Importance of Tumor Mitotic Rate Confirmed in 1317 Patients With Primary Cutaneous Melanoma and Long Follow-Up

Abstract: TMR was confirmed to be an important independent predictor of survival of patients with primary cutaneous melanoma. However, its predictive value was less than it was when assessed according to the 1982 revisions of the 1972 TMR recommendations.

Cited by 183 publications

References 26 publications

Age and gender are significant independent predictors of survival in primary cutaneous melanoma

Age and gender are significant independent predictors of survival in primary cutaneous melanoma

Single versus multiple primary melanomas

Chinese Guidelines on the Diagnosis and Treatment of Melanoma (2015 Edition)

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