Clinical and histopathological risk factors to predict sentinel lymph node positivity, disease-free and overall survival in clinical stages I–II AJCC skin melanoma: Outcome analysis from a single-institution prospectively collected database

Mandalà, Mario; Imberti, G.; Piazzalunga, Dario; Belfiglio, Maurizio; Labianca, Roberto; Barberis, Massimo; Marchesi, L.; Poletti, Paola; Bonomi, Lucia; Novellino, L.; Biagio, Katiuscia Di; Milesi, A.; Guerra, Ugo Paolo; Tondini, Carlo

doi:10.1016/j.ejca.2009.05.034

Cited by 86 publications

(72 citation statements)

References 27 publications

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“…In primary cutaneous melanoma Clark and colleagues were among the first to show the importance of tumor-infiltrating lymphocytes (TIL) as an independent predictor of patient survival (11). In recent years, several studies have confirmed this finding (12)(13)(14), while others found no significant correlation between TILs and clinical outcome (15)(16)(17). Adverse effects of TILs are also documented, for example, the presence of large numbers of regulatory T cells or myeloid-derived suppressor cells clearly correlated with poor survival after immunotherapy (18).…”

Section: Introductionmentioning

confidence: 48%

“…Further research should focus on unraveling the phenotype of the CD3 þ T cells and the underlying mechanisms that give rise to the strong predictive value of the I/P ratio. So far, most groups studying the correlation between TILs and patient survival classify the presence of TILs as absent, nonbrisk and brisk (11,15,16). Some characterize TILs only as present or absent (44), while few use a more elaborate method that takes both the distribution and the density of TILs into account (12).…”

Section: Discussionmentioning

confidence: 99%

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T-cell Landscape in a Primary Melanoma Predicts the Survival of Patients with Metastatic Disease after Their Treatment with Dendritic Cell Vaccines

et al. 2016

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Tumor-infiltrating lymphocytes appear to be a predictor of survival in many cancers, including cutaneous melanoma. We applied automated multispectral imaging to determine whether density and distribution of T cells within primary cutaneous melanoma tissue correlate with survival of metastatic melanoma patients after dendritic cell (DC) vaccination. CD3þ T cell infiltration in primary tumors from 77 metastatic melanoma patients was quantified using the ratio of intratumoral versus peritumoral T-cell densities (I/P ratio). Patients with longer survival after DC vaccination had stronger T-cell infiltration than patients with shorter survival in a discovery cohort of 19 patients (P ¼ 0.000026) and a validation cohort of 39 patients (P ¼ 0.000016). I/P ratio was the strongest predictor of survival in a multivariate analysis including M substage and serum lactate dehydrogenase level. To evaluate I/P ratio as a predictive biomarker, we analyzed 19 chemotherapy-treated patients. Longer survival times of DC-vaccinated compared with chemotherapytreated patients was observed for high (P ¼ 0.000566), but not low (P ¼ 0.154) I/P ratios. In conclusion, T-cell infiltration into primary melanoma is a strong predictor of survival after DC vaccination in metastatic melanoma patients who, on average, started this therapy several years after primary tumor resection. The infiltration remains predictive even after adjustment for late-stage prognostic markers. Our findings suggest that the I/P ratio is a potential predictive biomarker for treatment selection.

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Section: Introductionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 99%

T-cell Landscape in a Primary Melanoma Predicts the Survival of Patients with Metastatic Disease after Their Treatment with Dendritic Cell Vaccines

et al. 2016

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“…They also found that tumorinfiltrating lymphocytes (TIL) were a favorable feature. Although some studies have failed to demonstrate such an association (Gimotty et al, 2005;Taylor et al, 2007), other studies revealed that the presence of TIL in melanoma was associated with a favorable prognosis (Bogunovic et al, 2009;Mandala et al, 2009;Burton et al, 2011). A previous study (Taylor et al, 2007) showed that TILs predicted SLN positivity but, in contrast to other study (Azimi et al, 2012), were not associated with survival.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Multicenter Evaluation of Cutaneous Melanomas in Turkey

Gamsızkan¹,

Yılmaz²,

Büyükbabanı³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: We defined melanoma distribution in a large series of Turkish patients and evaluated the prognostic parameters of melanomas. Materials and Methods: A total of 1574 patients' data was retrospectively collected at 18 centers in Turkey. Demographic characteristics were questioned and noted. Prognostic parametres were evaluated based on sentinel lymph node involvement. Results: Mean age was 56.7 (4-99) years. While 844 (53.6%) cases were male, 730 (46.4%) cases were female. One thousand four hundred forty-seven (92%) cases were invasive melanoma and 127 (8%) cases were in-situ melanoma. The most common histopathological form was the superficial spreading melanoma (SSM) which was found in 549 patients (37.9%). It was followed by nodular melanoma in 379 (26.2%), acral lentiginous melanoma (ALM) in 191 (13.2%) and lentigo maligna melanoma in 132 (9.1%), respectively. On univariate analysis, lymphovascular invasion (p<0.001), tumor thickness (p<0.001), histopathological subtype (p<0.001), Clark level (p=0.001), ulceration (p<0.001), ≥6/mm 2 mitosis (p=0.005), satellite formation (p=0.001) and gender (p=0.03) were found to be associated with sentinel lymph node positivity. Regression was associated with sentinel lymph node negativity (p=0.017). According to multivariate analysis, lymphovascular invasion and tumor thickness were significant independent predictive factors of SLN positivity. Patient age, tumor localization, precursor lesions, lymphocytic infiltration and neurotropism were not related with sentinel lymph node involvement. Conclusions: In this retrospective analysis, it was found that the prevalence of SSM is at a lower rate while the prevalence of ALM is at a higher rate when compared to western countries. According to Breslow index; most of the melanoma lesions' thickness were greater than 2 mm, corresponding Clark IV. Vascular invasion and tumor thickness are the most important factors for sentinel lymph node involvement.

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“…15 Features routinely examined included BT (measured in millimeters), Clark level, presence or absence of ulceration, regression, and histologic subtype. Pathologists were blinded to patients' socioeconomic characteristics.…”

Section: Pathologic Featuresmentioning

confidence: 99%

Association of Socioeconomic Status With Breslow Thickness and Disease-Free and Overall Survival in Stage I-II Primary Cutaneous Melanoma

Mandalà¹,

Imberti²,

Piazzalunga

et al. 2011

Mayo Clinic Proceedings

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OBJECTIVE:To investigate the influence of socioeconomic status (SES) on Breslow thickness, disease-free survival, and overall survival in patients with stage I-II primary cutaneous melanoma (PCM). PATIENTS AND METHODS:The study consists of all consecutive patients who were diagnosed as having PCM and were treated and followed up at our hospital between November 1, 1998, and July 31, 2009. Pathologic and sociodemographic characteristics of the patients were obtained. We categorized SES into 3 levels: low (manual employees and skilled/unskilled workers, including farmers, with primary education level), middle (nonmanual employees and clerks with middle education level), and high (professionals, executives, administrators, and entrepreneurs with tertiary education).RESULTS: A total of 1443 consecutive patients were evaluated. In a multivariate logistic regression analysis, sex (female vs male: odds ratio [OR], 1.37; 95% confidence interval [CI], 1.08-1.75), SES (high vs middle: OR, 1.27; 95% CI, 0.96-1.69; high vs low: OR, 1.73; 95% CI, 1.26-2.38), age (<60 vs ≥60 years: OR, 1.35; 95% CI, 1.03-1.78), and family context (single vs living with relatives: OR, 1.37; 95% CI, 0.97-1.94) were the strongest correlates of Breslow thickness. Compared with high SES, the risk of melanoma-related death, adjusted for age and sex, was 7 times higher (hazard ratio, 7.44; 95% CI, 3.27-16.93) and almost 2 times higher (hazard ratio, 1.88; 95% CI, 1.04-3.39) in patients with low SES living alone or living with relatives, respectively. CONCLUSION:In patients with PCM, low SES is associated with thicker melanoma and a poorer clinical outcome. Proc. 2011;86(2):113-119 BT = Breslow thickness; CI = confidence interval; DFS = disease-free survival; HR = hazard ratio; OR = odds ratio; OS = overall survival; PCM = primary cutaneous melanoma; RECPAM = RECursive Partitioning and AMalgamation; SES = socioeconomic status Mayo Clin

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Clinical and histopathological risk factors to predict sentinel lymph node positivity, disease-free and overall survival in clinical stages I–II AJCC skin melanoma: Outcome analysis from a single-institution prospectively collected database

Cited by 86 publications

References 27 publications

T-cell Landscape in a Primary Melanoma Predicts the Survival of Patients with Metastatic Disease after Their Treatment with Dendritic Cell Vaccines

T-cell Landscape in a Primary Melanoma Predicts the Survival of Patients with Metastatic Disease after Their Treatment with Dendritic Cell Vaccines

A Retrospective Multicenter Evaluation of Cutaneous Melanomas in Turkey

Association of Socioeconomic Status With Breslow Thickness and Disease-Free and Overall Survival in Stage I-II Primary Cutaneous Melanoma

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