Tumor mitotic rate is a more powerful prognostic indicator than ulceration in patients with primary cutaneous melanoma

Azzola, Manuela F.; Shaw, Helen M.; Thompson, John F.; Soong, Seng‐Jaw; Scolyer, Richard A.; Watson, Geoffrey; Colman, Marjorie H.; Zhang, Yuting

doi:10.1002/cncr.11196

Cited by 381 publications

(256 citation statements)

References 28 publications

Supporting

Mentioning

219

Contrasting

Unclassified

Order By: Relevance

“…Another study also reported that high mitotic rate (per mm 2 ) was associated with poor prognosis and an important independent predictive factor of survival (Azzola et al, 2003). However, some authors stated that the mitotic rate was not an independent prognostic factor because it was significantly associated with tumor thickness and ulceration (Weedon, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…The presence of ulceration changes in the stage of TNM classification. Ulceration is regarded as an independent prognostic factor for melanoma (Ivan and Prieto, 2011); yet, some authors have not identified ulceration as an independently significant prognostic attribute (Azzola et al, 2003, Uysal-Sonmez et al, 2013, Wu et al, 2013. In addition, another study found that ulceration of the primary lesion was significantly associated with nodal disease on univariate, but not on multivariate analysis (Fontaine et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Retrospective Multicenter Evaluation of Cutaneous Melanomas in Turkey

Gamsızkan¹,

Yılmaz²,

Büyükbabanı³

et al. 2015

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

show abstract

“…25 In determining how the tumor mitotic rate should be categorized, it was established that the prognostic significance of the mitotic rate was strongest when comparing patients who had 0 mitoses/mm 2 and those who had !1 mitosis/mm 2 rather than grouping together patients with 0 mitoses/mm 2 and 1 mitosis/mm 2 . 25,32 The method by which the mitotic rate is measured also affects its utility as a prognostic indicator, and the current recommendation is to use the ''hotspot'' method (recording the highest total number of mitoses/mm 2 ) when evaluating the presence of mitotic figures as opposed to the alternative method of recording the mitoses per high-power field (HPF). 30,33 We analyzed the tumor mitotic rate recorded in our clinicopathologic melanoma database by its absence (0 mitoses/mm 2 or per HPF) or presence (!1 mitosis/mm 2 or per HPF).…”

Section: Discussionmentioning

confidence: 99%

Single versus multiple primary melanomas

Hwa

Price

Belitskaya-Lévy

et al. 2012

Cancer

View full text Add to dashboard Cite

BACKGROUND:In patients with multiple primary melanomas (MPM), mean tumor thickness tends to decrease from the first melanoma to the second melanoma, and prognosis may be improved compared with the prognosis for patients who have a single primary melanoma (SPM). In this study, the authors compared the clinicopathologic features of patients with MPM and SPM to better characterize the differences between these 2 groups and to determine whether or not there is an inherent difference in tumor aggression. METHODS: In total, 788 patients with melanoma who were enrolled prospectively in the Interdisciplinary Melanoma Cooperative Group database from 2002 to 2008 were studied. Patients with SPM and with MPM were compared with regard to clinical and primary melanoma characteristics. RESULTS: Of 788 patients with melanoma, 61 patients (7.7%) had 2 or more primary melanomas. The incidence of developing a second primary melanoma 1 year and 5 years after initial melanoma diagnosis was 4.1% and 8.7%, respectively, and most of the risk accumulated within the first year. The incidence of MPM was greater in patients aged !60 years than in those aged 60 years. The absence or presence of mitosis and other tumor characteristics did not differ significantly between patients with SPM and patients with MPM (P ¼ .61). CONCLUSIONS: No difference was observed in the presence or absence of mitoses, a marker of tumor proliferation, in SPM and MPM. Because it has been demonstrated that the presence of mitosis is a powerful prognostic marker, the current findings suggested that the tumors behave similarly in patients with SPM and patients with MPM. The authors concluded that differences in tumor thickness and prognosis between SPM and MPM more likely are caused by factors other than tumor biology, such as increased surveillance. Cancer 2012;118:4184-92.

show abstract

“…61 A mitotic rate of 1 or more per square millimeter was associated with a significant reduction in survivorship, 61 although in this data step-wise increases in mitotic activity did not show significant proportionate reduction in survival. 62 The Philadelphia group has shown a 10-year metastatic rate in men with vertical growth phase melanoma of 31% when a mitotic rate of greater than 0 was identified, vs a 4% mortality rate when the mitotic rate was 0. 63 Barnhill et al 58 studied the impact of mitotic rate upon survival for 650 consecutive primary cutaneous melanoma patients in a logistic regression model.…”

Section: Mitotic Ratementioning

confidence: 99%

Prognosticators of melanoma, the melanoma report, and the sentinel lymph node

2006

View full text Add to dashboard Cite

Since the 1960s, the clinical characteristics of melanoma, its histopathology and its biological basis have been the subject of intense study at pigmented lesion clinics in North America, Europe, and Australia. More recently, the immense database of the Melanoma Committee of the American Joint Committee on Cancer (AJCC) has been exploited through complex mathematical models to measure the impact of various histologic features of primary melanomas and of sentinel lymph node deposits and to correlate these parameters with patient survival. The wealth of modern information available to pathologists and clinicians has become of vital interest to the prognostication of the individual patient with melanoma. The purpose of this review is to bring to the attention of anatomic pathologists the essential characteristics of the pathology report for primary cutaneous melanoma in the modern era.

show abstract

Tumor mitotic rate is a more powerful prognostic indicator than ulceration in patients with primary cutaneous melanoma

Cited by 381 publications

References 28 publications

A Retrospective Multicenter Evaluation of Cutaneous Melanomas in Turkey

A Retrospective Multicenter Evaluation of Cutaneous Melanomas in Turkey

Single versus multiple primary melanomas

Prognosticators of melanoma, the melanoma report, and the sentinel lymph node

Contact Info

Product

Resources

About