Validation of a scoring system to predict non‐sentinel lymph node metastasis in melanoma

Cadili, Ali; McKinnon, Gregory; Wright, Frances C.; Hanna, Wedad; MacIntosh, Ethel; Abhari, Zahra; Dabbs, Kelly

doi:10.1002/jso.21465

Cited by 17 publications

(7 citation statements)

References 21 publications

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“…Nowadays, several studies have been committed to finding the signature of melanoma metastasis. Cadili et al (2010) considered the 2 and 5 mm for total sentinel lymph node metastasis as the cutoff value, which could effectively predict the non-sentinel lymph node metastasis in melanoma patients. Wardwell-Ozgo et al (2014) demonstrated that homeobox transcription factor A1 (HOXA1) mediated the cell invasion in melanoma cells, and primary tumors with high-expression HOXA1 were high-risk metastasis subgroups.…”

Section: Discussionmentioning

confidence: 99%

Predicting the Risk of Melanoma Metastasis Using an Immune Risk Score in the Melanoma Cohort

Sheng

Yan-ping

Liu

et al. 2020

Front. Bioeng. Biotechnol.

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Melanoma is a highly aggressive cancer, attracting increasing attention worldwide. The 5-year survival rate of patients with metastatic melanoma is low. Therefore, it is critical to identify potential effective biomarkers for diagnosis of melanoma metastasis. In the present study, the melanoma cohort and immune genes were obtained from the Cancer Genome Atlas (TCGA) database and the ImmPort database, respectively. Then, we constructed the immune risk score (IRS) using univariate and multivariate logistic analysis. The area under the curve (AUC) of IRS in sequencing samples and the initial diagnosis patients was 0.90 and 0.80, respectively. Besides, IRS could add benefits for metastasis diagnosis. For sequencing samples, IRS (OR = 16.35, 95% CI = 8.74-30.59) increased the odds for melanoma metastasis. Similar results were obtained in the initial diagnosis patients (OR = 8.93, 95% CI = 3.53-22.61). A composite nomogram was built based on IRS and clinical information with wellfitted calibration curves. We further used other independent melanoma cohorts from Gene Expression Omnibus (GEO) databases to confirm the reliability and validity of the IRS (AUC > 0.75, OR > 1.04, and P value < 0.01 in all cohorts). In conclusion, IRS is significantly associated with melanoma metastasis and can be a novel effective signature for predicting the metastasis risk.

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Section: Discussionmentioning

confidence: 99%

Predicting the Risk of Melanoma Metastasis Using an Immune Risk Score in the Melanoma Cohort

Sheng

Yan-ping

Liu

et al. 2020

Front. Bioeng. Biotechnol.

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“…Therefore, if absence of metastasis to the non‐SLN can be precisely predicted at the time of the SLNB, it would be possible to avoid the aforementioned complications without impairing the surgical curability. Multiple parameters used for microscopic classifications of metastatic SLN have been reported to date as being useful for the prediction of additional lymph node positivity, including the metastatic area, 10–12 number of positive SLN 13,14 and a combination of multiple factors; 15–19 of these, the following factors were re‐evaluated in this study: maximum diameter (maximum diameter of the largest tumor lesion in the SLN), 4,20–24 invasion depth (depth of tumor invasion measured from the capsule of the SLN) 6,25–27 and microanatomic location (microanatomic location of the tumor deposit within the SLN) 7 . The factors that were identified as being predictive of an additional lymph node positivity rate of 0% were a maximum diameter of the lesion of less than 0.1 mm 20 or not more than 0.2 mm, 22 an invasion depth of not more than 1.0 mm, 25 a subcapsular microanatomic location, 7 a metastatic area of not more than 0.3 mm 2 , 11 presence of less than two positive SLN, 14 and a combination of factors, comprising an invasion depth of not more than 2 mm, a metastatic area of not more than 10 mm 2 and absence of perinodal involvement 15 .…”

Section: Discussionmentioning

confidence: 99%

“…It may be possible to suggest omission of CLND or reduction in the extent of regional lymphadenectomy in such patients. There have also been reports recently documenting prediction of additional lymph node positivity based on scoring systems devised using the patient background characteristics and characteristics of the primary lesion, besides the above‐mentioned microscopic classification of metastatic SLN 18,19,28,29 . Of these scoring systems, the N‐SNORE 29 appears to be of particular interest, as it seems to offer the promise of more appropriate prediction of additional lymph node positivity than any of the currently published classification systems.…”

Section: Discussionmentioning

confidence: 99%

Prediction of additional lymph node positivity and clinical outcome of micrometastases in sentinel lymph nodes in cutaneous melanoma: A multi‐institutional study of 450 patients in Japan

Namikawa

Yamazaki

Nakai

et al. 2011

The Journal of Dermatology

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Various microscopic classifications of metastatic sentinel lymph nodes (SLN) have been reported along with predictors of additional lymph node positivity and their correlations with the prognosis. The purpose of this study was to re-evaluate these classifications in the Japanese population. We selected the following three classifications, based on the procedural simplicity of the measurements: maximum diameter (maximum diameter of the largest tumor lesion in the SLN; <0.1, 0.1-1.0, >1.0 mm), invasion depth (depth of tumor invasion measured from the capsule in the SLN; SI ≤ 0.3 mm, SII >0.3 to ≤ 1.0 mm, SIII >1.0 mm), and microanatomic location (microanatomic location of the tumor deposits within the SLN; "subcapsular", "parenchymal", "combined", "multifocal", "extensive"). A retrospective study, using prescribed survey forms, was carried out. Among the 450 patients, including the 149 cases with SLN metastasis, an additional lymph node positivity rate of 0% could be predicted only in patients with a maximum diameter category of less than 0.1 mm. As compared with that in the SLN metastasis-negative cases, however, the prognosis was poorer in cases with SLN metastasis, even those with lesions falling under the maximum diameter category of less than 0.1 mm, invasion depth category of SI (≤ 0.3 mm) and microanatomic location category of subcapsular. The prognosis is particularly poor for the microanatomic location category of extensive, which should thus be regarded as a macrometastasis. A prospective study with standardized procedures, including pathological evaluation, is needed in order to confirm our conclusion.

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“…Azoknál a betegeknél, akiknél pozitív SLN került eltávolításra, a publikált közlemények eredményei szerint az elvégzett blokkdisszekcióval hozzávetőlegesen 20%-ban észleltek további pozitív nyirokcsomót. Azok a faktorok, amelyek a leginkább előrejelzik a további nyirokcsomó pozitivitást, a következők: a SLN legnagyobb mérete, az érintett sentinel nyirokcsomók száma, a metasztázis elhelyezkedése/megjelenése a nyirokcsomón belül (subscapuláris, vagy parenchymalis), és a primer tumor jellemzői, mint vastagság, ulceráció (32,56,(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75).…”

Section: A Blokkdisszekció Prognosztikai Jelentősége éS Terápiás Hasznaunclassified

Progress in the surgical treatment of cutaneous melanoma

Kis¹,

Kádár²,

Juhász³

2017

BVSZ

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A melanoma malignum kezelésében a korábbi mechanikus szemléletet felváltotta az ún. biológiai szemlélet, melynek során a szervezet tumorellenes mechanizmusait igyek szünk támogatni. Ez a szemléletváltás a melanoma sebészeti kezelésben a primer tumor körüli biztonsági zóna lecsökkentéséhez és az őrszem (sentinel) nyirokcsomó biopszia bevezetéséhez vezetett. A melanoma terápiájában manapság a sebészre négy meghatározó feladat hárul: a primer tumor eltávolítása, sentinel nyirokcsomó biopszia valamint blokkdisszekció elvégzése és a bőrmetasztázisok sebészi ellátása. Jelen összefoglaló közleményben a szerzők a legfrissebb nemzetközi irányelvek, tudományos eredmények és saját gyakorlatuk alapján részletes áttekintést nyújtanak a melanoma műtéti ellátásáról, beszámolnak a nem rezekábilis bőráttétek kezelésében hasz nálatos új eljárásról, a hazánkban is elérhető elektrokemoterápiáról. Kulcsszavak: melanoma malignum-biztonsági zónasentinel nyirokcsomó-blokkdisszekció-elektrokemoterápia SUMMARY Recently the biological approach dominates in the treatment of malignant melanoma, which means the support of the antitumor defense of the organism. This view has led to diminished safety margins at the removal of the primary tumor and introduction of sentinel lymph node biopsy. Nowadays surgeons have four main tasks in the treatment of melanoma: excision of primary tumor, sentinel lymph node biopsy, regional lymph node dissection, and surgical treatment of the metastases. Based on the latest international guidelines, published data, and best practices authors summarize the current surgical therapies of cutaneous malignant melanoma, and also account on electrochemotherapy, which is a new, effective treatment of the irresecable cutaneous metastases.

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Validation of a scoring system to predict non‐sentinel lymph node metastasis in melanoma

Cited by 17 publications

References 21 publications

Predicting the Risk of Melanoma Metastasis Using an Immune Risk Score in the Melanoma Cohort

Predicting the Risk of Melanoma Metastasis Using an Immune Risk Score in the Melanoma Cohort

Prediction of additional lymph node positivity and clinical outcome of micrometastases in sentinel lymph nodes in cutaneous melanoma: A multi‐institutional study of 450 patients in Japan

Progress in the surgical treatment of cutaneous melanoma

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