Mitotic rate correlates with sentinel lymph node status and outcome in cutaneous melanoma greater than 1 millimeter in thickness: A multi-institutional study of 1524 cases

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• 作者：Mario Mandalà ; MD^a ; ^{mariomandala@tin.it} ; ^{mmandala@asst-pg23.it} ; Francesca Galli ; StatSci^b ; Laura Cattaneo ; MD^c ; Barbara Merelli ; MD^a ; Eliana Rulli ; StatSci^b ; Simone Ribero ; MD^d ; Pietro Quaglino ; MD^d ; Vincenzo De Giorgi ; MD^e ; Jacopo Pigozzo ; MD^f ; Vanna Chiarion Sileni ; MD^f ; Alessandra Chirco ; MD^a ; Pier Francesco Ferrucci ; MD^g ; Marcella Occelli ; MD^h ; Gianlorenzo Imberti ; MDⁱ ; Dario Piazzalunga ; MD^j ; Daniela Massi ; MD^k ; Carlo Tondini ; MD^a ; Paola Queirolo ; MD^l ; on behalf of Italian Melanoma Intergroup
• 关键词：mitotic rate ; cutaneous melanoma ; prognosis ; disease-free survival ; overall survival ; sentinel lymph node ; outcome
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：76
• 期：2
• 页码：264-273.e2
• 全文大小：904 K
• 卷排序：76

文摘

The 7th edition of the TNM American Joint Committee on Cancer classification incorporates mitotic rate (MR) only for primary cutaneous melanoma (PCM) with Breslow thickness (BT) ≤1 mm.ObjectiveTo investigate whether and to what extent MR is able to predict sentinel lymph node (SLN) status and clinical outcome of PCM patients with BT >1 mm.MethodsThe study included consecutive patients with PCM. Logistic regression and Cox regression model were used to analyze the impact of MR on SLN status, disease-free survival (DFS), and overall survival.ResultsFrom 1998 to 2015, 1524 PCM (median age 57.8 years) cases were diagnosed with a BT >1 mm in six centers of the Italian Melanoma Intergroup. Median follow-up was 5.0 years. By multivariate analysis, MR was associated with SLN positivity (odds ratio 1.98, 95% confidence interval [CI] 1.12-3.50, P = .018). After adjusting for BT, ulceration, age, sex, and SLN status, MR correlated with a poor DFS (hazard ratio 1.52, 95% CI 1.18-1.97, P = .002) and overall survival (hazard ratio 1.63, 95% CI 1.17-2.29, P = .004).LimitationsRetrospective analysis.ConclusionMR is an independent prognostic factor for PCM patients with BT >1 mm. Incorporating this tissue biomarker could provide a better stratification of patients entering clinical trials in the adjuvant setting.