Progressive Disease in Sentinel-negative Melanoma Patients: Biological Differences and Importance of Sentinel Lymph Node Biopsy.


Journal

Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988

Informations de publication

Date de publication:
Feb 2020
Historique:
received: 04 01 2020
revised: 16 01 2020
accepted: 17 01 2020
entrez: 5 2 2020
pubmed: 6 2 2020
medline: 20 3 2020
Statut: ppublish

Résumé

Among the most important prognostic factors in melanoma is the sentinel lymph node (SLN) status. Using our electronic database we identified 109 of 890 SLN-negative patients with progressive disease (PD). These patients were characterized for melanoma type, molecular type, sequence and extent of metastatic spread. A total of 61 of 109 SLN-negative patients had PD in the SLN-basin indicating false-negative SLN (group-1). Forty eight of 109 patients had PD at distant sites and were therefore impossible to be identified using SLN biopsy (group-2). Despite distant spread these patients had significantly more single organ metastasis (p<0.001) and significantly longer disease-free-survival (p=0.001) compared to group-1. Additionally, to significant differences on a molecular basis between the two groups (p=0.01), all lentigo maligna and spindle-cell-melanomas belonged to group-2 and all, except one lentigo maligna melanoma, had single visceral metastasis. Two different biological groups among SLN-negative patients with PD were demonstrated. Extravascular-migratory-metastasis, rather than hematogenous spread, might be responsible for the observed PD with single organ involvement.

Sections du résumé

BACKGROUND/AIM OBJECTIVE
Among the most important prognostic factors in melanoma is the sentinel lymph node (SLN) status.
MATERIALS AND METHODS METHODS
Using our electronic database we identified 109 of 890 SLN-negative patients with progressive disease (PD). These patients were characterized for melanoma type, molecular type, sequence and extent of metastatic spread.
RESULTS RESULTS
A total of 61 of 109 SLN-negative patients had PD in the SLN-basin indicating false-negative SLN (group-1). Forty eight of 109 patients had PD at distant sites and were therefore impossible to be identified using SLN biopsy (group-2). Despite distant spread these patients had significantly more single organ metastasis (p<0.001) and significantly longer disease-free-survival (p=0.001) compared to group-1. Additionally, to significant differences on a molecular basis between the two groups (p=0.01), all lentigo maligna and spindle-cell-melanomas belonged to group-2 and all, except one lentigo maligna melanoma, had single visceral metastasis.
CONCLUSION CONCLUSIONS
Two different biological groups among SLN-negative patients with PD were demonstrated. Extravascular-migratory-metastasis, rather than hematogenous spread, might be responsible for the observed PD with single organ involvement.

Identifiants

pubmed: 32014933
pii: 40/2/891
doi: 10.21873/anticanres.14022
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

891-899

Informations de copyright

Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Auteurs

Anna Conrad (A)

Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.

Michael Reinehr (M)

Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.

David Holzmann (D)

University of Zurich, Zurich, Switzerland.
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.

Joanna Mangana (J)

University of Zurich, Zurich, Switzerland.
Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.

Miriam Wanner (M)

University of Zurich, Zurich, Switzerland.
Cancer Registry Zurich and Zug, University Hospital Zurich, and Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland.

Martin Huellner (M)

University of Zurich, Zurich, Switzerland.
Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.

Raymond L Barnhill (RL)

Departments of Pathology and Translational Research, Institute Curie, Paris, France.

Claire Lugassy (C)

Departments of Pathology and Translational Research, Institute Curie, Paris, France.

Nicole Lindenblatt (N)

University of Zurich, Zurich, Switzerland.
Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.

Daniela Mihic-Probst (D)

Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland dmihic-probst@hin.ch.
University of Zurich, Zurich, Switzerland.

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Classifications MeSH