The sentinel lymph node spread determines quantitatively melanoma seeding to non-sentinel lymph nodes and survival

Ulmer, Anja; Dietz, Klaus; Werner-Klein, Melanie; Häfner, Hans‐Martin; Schulz, Claudia; Renner, Philipp; Weber, Florian; Breuninger, Helmut; Röcken, Martin; Garbe, Claus; Fierlbeck, Gerhard; Klein, Christoph

doi:10.1016/j.ejca.2017.12.002

Cited by 13 publications

(6 citation statements)

References 30 publications

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“…There is evidence that risk stratification for adjuvant treatments can be done based on ulceration and nodal tumor burden in patients with a positive sentinel node, regardless of CLND. 34–36 This reinforces the importance of SNB and an adequate identification of high-risk patients.…”

Section: Discussionsupporting

confidence: 61%

Development and validation of a Brazilian nomogram to assess sentinel node biopsy positivity in melanoma

Bertolli

Calsavara

Macêdo

et al. 2020

Tumori

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Background: Although well-established, sentinel node biopsy (SNB) for melanoma is not free from controversies and sometimes it can be questionable if SNB should be considered even for patients who meet the criteria for the procedure. Mathematical tools such as nomograms can be helpful and give more precise answers for both clinicians and patients. We present a nomogram for SNB positivity that has been internally validated. Methods: Retrospective analysis of patients who underwent SNB from 2000 to 2015 in a single institution. Single logistic regressions were used to identify variables that were associated to SNB positivity. All variables with a p value < 0.05 were included in the final model. Overall performance, calibration, and discriminatory power of the final multiple logistic regression model were all assessed. Internal validation of the multiple logistic regression model was performed via bootstrap analysis based on 1000 replications. Results: Site of primary lesion, Breslow thickness, mitotic rate, histologic regression, lymphatic invasion, and Clark level were statistically related to SNB positivity. After internal validation, a good performance was observed as well as an adequate power of discrimination (area under the curve 0.751). Conclusions: We have presented a nomogram that can be helpful and easily used in daily practice for assessing SNB positivity.

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Section: Discussionsupporting

confidence: 61%

Development and validation of a Brazilian nomogram to assess sentinel node biopsy positivity in melanoma

Bertolli

Calsavara

Macêdo

et al. 2020

Tumori

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“…Therefore, we argue to not routinely perform CLND in case of a positive SN. Others share this opinion and have suggested other alternatives such as routinely harvesting 4e5 nodes during a SLNB [24] or using a prognostic model that incorporates the disseminated cancer cell density in the SN [25].…”

Section: Discussionmentioning

confidence: 99%

Risk stratification of sentinel node positive melanoma patients defines surgical management and adjuvant therapy treatment considerations

Verver

Klaveren

Akkooi

et al. 2019

European Journal of Surgical Oncology

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“…However, less extensive and more precise techniques are needed. We recently showed that the quantitative analysis of DCCs from disaggregated LN enables an accurate evaluation of the metastatic spread . While this approach allows analysis of the entire LN and not only selected sections, the time‐consuming screening step of millions of lymph node cells remains a limitation.…”

Section: Introductionmentioning

confidence: 99%

“…We recently showed that the quantitative analysis of DCCs from disaggregated LN enables an accurate evaluation of the metastatic spread. 2,10,11 While this approach allows analysis of the entire LN and not only selected sections, the time-consuming screening step of millions of lymph node cells remains a limitation. Automation, especially in combination with better DCC enrichment strategies, would strongly enhance applicability in diagnostic workflows.…”

Section: Introductionmentioning

confidence: 99%

Microfluidic enrichment, isolation and characterization of disseminated melanoma cells from lymph node samples

Weidele

Stojanović

Feliciello

et al. 2019

Intl Journal of Cancer

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For the first time in melanoma, novel therapies have recently shown efficacy in the adjuvant therapy setting, which makes companion diagnostics to guide treatment decisions a desideratum. Early spread of disseminated cancer cells (DCC) to sentinel lymph nodes (SLN) is indicative of poor prognosis in melanoma and early DCCs could therefore provide important information about the malignant seed. Here, we present a strategy for enrichment of DCCs from SLN suspensions using a microfluidic device (Parsortix™, Angle plc). This approach enables the detection and isolation of viable DCCs, followed by molecular analysis and identification of genetic changes. By optimizing the workflow, the established protocol allows a high recovery of DCC from melanoma patient‐derived lymph node (LN) suspensions with harvest rates above 60%. We then assessed the integrity of the transcriptome and genome of individual, isolated DCCs. In LNs of melanoma patients, we detected the expression of melanoma‐associated transcripts including MLANA (encoding for MelanA protein), analyzed the BRAF and NRAS mutational status and confirmed the malignant origin of isolated melanoma DCCs by comparative genomic hybridization. We demonstrate the feasibility of epitope‐independent isolation of LN DCCs using Parsortix™ for subsequent molecular characterization of isolated single DCCs with ample application fields including the use for companion diagnostics or subsequent cellular studies in personalized medicine.

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The sentinel lymph node spread determines quantitatively melanoma seeding to non-sentinel lymph nodes and survival

Cited by 13 publications

References 30 publications

Development and validation of a Brazilian nomogram to assess sentinel node biopsy positivity in melanoma

Development and validation of a Brazilian nomogram to assess sentinel node biopsy positivity in melanoma

Risk stratification of sentinel node positive melanoma patients defines surgical management and adjuvant therapy treatment considerations

Microfluidic enrichment, isolation and characterization of disseminated melanoma cells from lymph node samples

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