Prognostic Significance of Extent of Ulceration in Primary Cutaneous Melanoma

Sarpa, Hege Grande; Reinke, Kara A.; Shaikh, Ladan; Leong, Stanley P. L.; Miller, James R.; Sagebiel, Richard W.; Kashani‐Sabet, Mohammed

doi:10.1097/01.pas.0000213262.61855.7d

Cited by 47 publications

(29 citation statements)

References 18 publications

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“…There is a relationship between the presence of ulceration and survival [18, 19]. Similarly to the documentation of microsatellites, it is important to document the absence of evidence of ulceration within a specimen [10, 20].…”

Section: Discussionmentioning

confidence: 99%

Completeness of Histopathology Reporting of Melanoma in a High-Incidence Geographical Region

et al. 2008

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Background: Appropriate histopathology reporting helps to ensure effective therapy and prognosis. Objective: Toexamine compliance with clinical practice guidelines for histopathology reports of melanomas. Methods: A sample of melanoma histopathology reports in Queensland was audited for inclusion of recommended information. The quality of documentation was constructed and multivariate analysis used to determine factors affecting the quality of reporting practices. Results: Documentation of the most important features of melanoma was high: clear diagnosis (99.8%; 95% CI 98.6–100), thickness (99.8%; 95% CI 98.6–100), comment on adequacy of excision (87.9%; 95% CI 84.9–91.0) and measurement of margins (91.9%; 95% CI 88.8–91.4). Overall reporting of ulceration and regression was of lesser completeness (83.0 and 77.8%, respectively) and these features were more likely to be reported by high-volume laboratories (p < 0.001 and p = 0.037, respectively). This trend was not apparent for other features. Fewer than 50% of reports documented mitotic rate per square millimetre, predominant cell type, microsatellites, growth phase and desmoplasia. Conclusion: Awareness of current reporting practices and identification of areas in which insufficiencies exist enable the revision of systems and potential improvements to the transfer of information to treating clinicians.

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Section: Discussionmentioning

confidence: 99%

Completeness of Histopathology Reporting of Melanoma in a High-Incidence Geographical Region

et al. 2008

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“…In addition, it has been advanced that ulcerated melanomas show greater response rates to interferon therapy [3, 5, 13]. Work by Sarpa and colleagues demonstrated a significant relationship between the percentage of the tumor that is ulcerated and both sentinel lymph node status and OS; even minimal ulceration worsens the overall prognosis [14]. Moreover, ulceration, along with tumor thickness and disease stage, was shown to be one of the three risk factors most associated the development of brain metastasis [15].…”

Section: Introductionmentioning

confidence: 99%

Immune biomarkers are more accurate in prediction of survival in ulcerated than in non-ulcerated primary melanomas

Moll

Qian

et al. 2015

Cancer Immunol Immunother

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Introduction Ulcerated melanomas may have a unique biology and microenvironment. We test whether markers of immune infiltration correlate with clinical outcome in ulcerated compared to non-ulcerated primary melanoma tumors. Methods Sixty-two stage II–III cutaneous melanomas, 32 ulcerated and 30 non-ulcerated, were analyzed for tumor-infiltrating lymphocytes (TILs). Immunohistochemistry (IHC) was performed for CD2, a marker previously shown to correlate with overall survival (OS) and recurrence-free survival (RFS) in this patient population. IHC using antibody, VE1, to BRAF V600E was also performed on a subset of 41 tumors to assess the relationship of BRAF mutation to immune markers. Results We found, using Cox regression models, that the presence of TILs was associated with improved OS (p = 0.034) and RFS (p = 0.002) in ulcerated melanoma tumors, but not in non-ulcerated melanoma (p = 0.632, 0.416). CD2 expression also was correlated with improved OS (p = 0.021) and RFS (p = 0.001) in ulcerated melanoma, but no relationship was seen in non-ulcerated melanoma (p = 0.427, 0.682). In this small population, BRAF status did not correlate with TILs or CD2+ count. Conclusion Our data show that immune markers including TILs and CD2 count correlate more closely with survival in ulcerated melanomas than that in non-ulcerated melanomas. We propose that immune biomarkers may be particularly relevant to ulcerated, as compared to non-ulcerated, melanomas and that this merits study in larger populations.

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“…The prognosis of melanoma with ulcer formation is worse than that of melanoma without ulcer formation (Grande et al, 2006). Skin ulcer seems to cause the cutaneous cell types of the dermis under the epidermis to situate at ALI by the ulcer-induced exposure of them to atmospheric air.…”

Section: Mechanisms Of Ali-related Behavior Of Melanoma Cellsmentioning

confidence: 99%

“…Thus, the epidermal microenvironments seem crucial for the initiation and progression of melanoma cells. Furthermore, the prognosis of melanoma with ulcer formation is worse than that of melanoma without ulcer formation (Grande et al, 2006). Given that skin ulcer causes cutaneous cell types under the epidermis to situate at ALI by the ulcer-induced exposure of them to atmospheric air, ALI may be related to the growth and invasion of melanoma cells.…”

Section: Introductionmentioning

confidence: 99%