Observational study on the mitotic rate and other prognostic factors in cutaneous primary melanoma arising from naevi and from melanoma <i>de novo</i>

Betti, Roberto; Santambrogio, Roberto; Cerri, Amilcare; Vergani, Raffaella; Moneghini, Laura; Menni, S.

doi:10.1111/jdv.12395

Cited by 13 publications

(4 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study also found that nevus-associated melanomas were more likely to be associated with thinner tumors, and thus had a better prognosis in general. Although some previous studies have reported that Breslow thickness did not differ significantly in nevus-associated versus de novo melanomas, thinner tumors have been found to be associated with an increased likelihood of nevus-associated melanoma in other reports [6, 11, 12, 24, 26–29]. More specifically, nevus-associated melanomas were reported to be more frequent in thinner tumors, possibly owing to the obliteration of nevocytic remnants in more advanced melanomas [12, 24].…”

Section: Discussionmentioning

confidence: 85%

“…The histologic melanoma subtypes were classified as ALMs, SSMs, NMs, LMMs, mucosal melanomas, and desmoplastic melanomas. According to a recent study [11], the mitotic count was categorized into groups of <1 mitosis/mm 2 , 1–5 mitoses/mm 2 , and ≥ 6 mitoses/mm 2 . Lesions distributed on the trunk and extremities were acknowledged to be distributed on areas receiving intermittent sun exposure; lesions on the head and neck were regarded as being located on areas receiving chronic sun exposure; and the acral and genital areas were recognized as non-sun-exposed areas [12].…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Clinicopathological features and prognosis of patients with de novo versus nevus-associated melanoma in Taiwan

et al. 2017

View full text Add to dashboard Cite

Studies surveying melanomas associated with melanocytic nevi in Asia are rare. In this study, we examined whether nevus-associated melanomas differ from de novo melanomas in terms of their associations with clinical factors, histologic characteristics, and patient survival in Taiwan. Using data on cancer cases obtained from the Department of Pathology archives and the Cancer Registry of National Taiwan University Hospital, we conducted a retrospective analysis of 103 consecutive melanoma patients who were diagnosed between 2010 and 2015 and received follow-up through November 2016. Approximately 17.5% of the melanomas in question were associated with a nevus. In patients under 65 years of age, non-acral lentiginous melanomas were significantly associated with a higher percentage of nevus-associated melanomas. The superficial spreading subtype, younger patient age, thinner tumor, intermittent solar exposure, and early stage were significant predictors of a melanoma being histologically associated with a nevus. The appearance of a nevus associated with a melanoma predicted better recurrence-free survival compared with de novo melanomas. Although acral lentiginous melanomas (70.9%) constituted the most common histologic subtype, only 9.6% of the acral lentiginous melanomas were associated with a nevus. Furthermore, there was no statistically significant difference between the nevus-associated and de novo acral lentiginous melanomas with regard to clinicopathological factors and survival. In conclusion, nevus-associated melanomas were uncommon among acral lentiginous melanomas. Relatedly, because over half of all melanomas in Asians are acral lentiginous melanomas, Asians are less likely than Caucasians to have nevus-associated melanomas.

show abstract

Section: Discussionmentioning

confidence: 85%

Section: Methodsmentioning

confidence: 99%

Clinicopathological features and prognosis of patients with de novo versus nevus-associated melanoma in Taiwan

et al. 2017

View full text Add to dashboard Cite

show abstract

“…A recent review demonstrated that a single mitosis in thin melanomas did not increase the risk of sentinel lymph node positivity, although it was related to a significant decrease in survival rate [ 33 ]. A retrospective study comparing de novo melanomas and nevus-associated melanomas found that there are no prognostic differences when the mitotic rate is considered for one or more mitoses; however, there are prognostic differences when this criterion is considered for more than five mitoses, which raises the question of what should be the cut-off point for this variable [ 34 ]. Indeed, as discussed in [ 14 ], incorporating the MR into the staging system has proven difficult given the nonlinear nature of its impact on survival.…”

Section: Discussionmentioning

confidence: 99%

Could the mitotic count improve personalized prognosis in melanoma patients?

Buja,

Rugge,

Cozzolino

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

A number of studies have indicated that the mitotic rate may be a predictive factor for poor prognosis in melanoma patients. The aim of this study was to investigate whether the mitotic rate is associated with other prognostic clinical and anatomopathological characteristics. After adjusting for other anatomopathological characteristics, we then verified the prognostic value of the number of mitoses, determining in which population subgroup this variable may have greater prognostic significance on 3-year mortality. The Veneto Cancer Registry (Registro Tumori del Veneto—RTV), a high-resolution population-based dataset covering the regional population of approximately 4.9 million residents, served as the clinical data source for the analysis. Inclusion criteria included all incident cases of invasive cutaneous malignant melanoma recorded in the RTV in 2015 (1,050 cases) and 2017 (1,205 cases) for which the number of mitoses was available. Mitotic classes were represented by Kaplan–Meier curves for short-term overall survival. Cox regression calculated hazard ratios in multivariable models to evaluate the independent prognostic role of different mitotic rate cut-offs. The results indicate that the mitotic rate is associated with other survival prognostic factors: the variables comprising the TNM stage (e.g., tumor thickness, ulceration, lymph node status and presence of metastasis) and the characteristics that are not included in the TNM stage (e.g., age, site of tumor, type of morphology, growth pattern and TIL). Moreover, this study demonstrated that, even after adjusting for these prognostic factors, mitoses per mm2 are associated with higher mortality, particularly in T2 patients. In conclusion, these findings revealed the need to include the mitotic rate in the histological diagnosis because it correlates with the prognosis as an independent factor. The mitotic rate can be used to develop a personalized medicine approach in the treatment and follow-up monitoring of melanoma patients.

show abstract

“…The independent prognostic value of the mitotic rate has been described in various studies [ 7 , 29 , 38 , 39 , 40 , 41 ]. Despite these results, there is still no consensus regarding the prognostic cut-off value for the number of mitoses as different studies have used various thresholds, such as absent vs. present, ≥1/mm 2 , ≥2/mm 2 , or 5 mitoses/mm 2 [ 1 , 42 , 43 , 44 , 45 ]. Moreover, the significant cut-off values may vary based on the tumor stage, and further studies are required to fully establish how the mitotic index should be reported in cutaneous melanomas [ 7 , 40 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Value of Proliferative Activity in Cutaneous Melanoma: A Pilot Study Evaluating the Mitotic Rate and Ki67 Index to Predict Patient Outcomes

Tapoi,

Gheorghișan-Gălățeanu,

Gosman

et al. 2024

Biomedicines

View full text Add to dashboard Cite

Proliferative activity in cutaneous melanomas can be appreciated both histopathologically by counting mitotic figures and immunohistochemically through the Ki67 index, but the prognostic value of each method is still a matter of debate. In this context, we performed a retrospective study on 33 patients diagnosed with cutaneous melanomas between 2013 and 2018 in order to evaluate progression-free survival and overall survival. Multivariate Cox proportional hazards regression was performed by considering both clinical histopathological and immunohistochemical features. The mitotic rate was significantly independently associated with both outcomes, while the Ki67 index was not an independent prognostic factor. However, the Ki67 predictive accuracy could be improved by establishing both a cut-off value and a standardized protocol for evaluating its expression. Until these desiderata are met, the mitotic rate remains superior to the Ki67 index for predicting prognosis in cutaneous melanomas, as also has the advantage of being easily interpreted in a standard histopathological examination regardless of the pathologist’s experience and with no further financial expenses. Importantly, this is one of very few articles that has shown perineural invasion to be an independent prognostic factor for both progression-free survival and overall survival in cutaneous melanomas. As a consequence, this parameter should become a mandatory feature in the histopathological evaluation of cutaneous melanomas as it can improve the identification of patients who are at high risk for disease progression.

show abstract

Observational study on the mitotic rate and other prognostic factors in cutaneous primary melanoma arising from naevi and from melanoma de novo

Cited by 13 publications

References 20 publications

Clinicopathological features and prognosis of patients with de novo versus nevus-associated melanoma in Taiwan

Clinicopathological features and prognosis of patients with de novo versus nevus-associated melanoma in Taiwan

Could the mitotic count improve personalized prognosis in melanoma patients?

The Prognostic Value of Proliferative Activity in Cutaneous Melanoma: A Pilot Study Evaluating the Mitotic Rate and Ki67 Index to Predict Patient Outcomes

Contact Info

Product

Resources

About