Speed rate (SR) as a new dynamic index of melanoma behavior.
Breslow
melanoma
mitoses
prognostic factors
sentinel lymph node
Journal
Pigment cell & melanoma research
ISSN: 1755-148X
Titre abrégé: Pigment Cell Melanoma Res
Pays: England
ID NLM: 101318927
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
21
01
2020
revised:
30
04
2020
accepted:
06
05
2020
pubmed:
15
5
2020
medline:
11
6
2021
entrez:
15
5
2020
Statut:
ppublish
Résumé
Melanomas are skin tumors that show a variety of biological behavior. Some develop very fast and some other grow extremely slow, with metastasis appearing, eventually, many years after the diagnosis. The number of mitoses in primary melanoma has been related to a more aggressive tumor and may have a potential as predictive factor for cutaneous melanoma survival. However, tumor mitotic rate is a static measure and in multivariate analysis on tumor survival, it has scored less than other tumor characteristics. We tried to evolve tumor mitotic rate from a static parameter to a time-dependent one. Similar to the already described growth rate (GR), we propose the speed rate (SR). SR is defined as the ratio of tumor mitotic rate to time to melanoma development. A prospective series of 345 patients with melanoma was investigated for the role of SR as predictive factor for sentinel lymph node (SLN) positivity and tumor progression. We calculated the best threshold for SR and GR to predict the risk of recurrence. Melanoma clinical and histological characteristics as well as GR were correlated in a multivariated analysis with SR. SR values >0.2 mitoses/month were associated with negative prognostic factors such as ulceration (82.8%), SLN positivity (80%), progression (82.8%), and death (85.7%). The association of GR > 0.3 mm/months and SR > 0.2 mitoses/month had a significant predictive value in terms of SLN positivity, progression, and recurrence-free survival. We propose SR as a new "dynamic" predictor of histological SLN positivity and melanoma recurrence risk. We think that he association with this new feature with GR may be helpful in improving the accuracy of predicted clinical outcome of patient especially with thin melanomas.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
709-718Investigateurs
Kristine Pelusi
(K)
Adelchi Croce
(A)
Alfonso D'Orazio
(A)
Fabio De Francesco
(F)
Fiamma Buttitta
(F)
Massimo Ippoliti
(M)
Rocco Mazza
(R)
Maria Taraborrelli
(M)
Nicola D'Ostilio
(N)
Giuseppe Martino
(G)
Clara Natoli
(C)
Luigi Guetti
(L)
Roberta Cianci
(R)
Informations de copyright
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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