Prognostic Significance of a Positive Nonsentinel Lymph Node in Cutaneous Melanoma

2011 ◽  
Vol 2011 ◽  
pp. 398-399
Author(s):  
L. Meadows ◽  
A. Torres
Keyword(s):  
Lymph Node ◽  
Cutaneous Melanoma ◽  
Prognostic Significance ◽  
Nonsentinel Lymph Node

Prognostic Significance of a Positive Nonsentinel Lymph Node in Cutaneous Melanoma

2009 ◽  
Vol 16 (11) ◽  
pp. 2978-2984 ◽  
Author(s):  
Amir A. Ghaferi ◽  
Sandra L. Wong ◽  
Timothy M. Johnson ◽  
Lori Lowe ◽  
Alfred E. Chang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Cutaneous Melanoma ◽  
Prognostic Significance ◽  
Nonsentinel Lymph Node

Tumor-Infiltrating Lymphocytes Predict Sentinel Lymph Node Positivity in Patients With Cutaneous Melanoma

2007 ◽  
Vol 25 (7) ◽  
pp. 869-875 ◽  
Author(s):  
Rebecca C. Taylor ◽  
Ami Patel ◽  
Katherine S. Panageas ◽  
Klaus J. Busam ◽  
Mary S. Brady
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Cutaneous Melanoma ◽  
Prognostic Significance ◽  
Tumor Infiltrating Lymphocytes ◽  
Breslow Thickness ◽  
Anatomic Site ◽  
Primary Cutaneous Melanoma ◽  
Male Sex ◽  
Infiltrating Lymphocytes

Purpose Tumor-infiltrating lymphocytes (TILs) are considered a manifestation of the host immune response to tumor, but the influence of TILs on outcome remains controversial. Studies evaluating the prognostic significance of TILs were published before routine examination of draining lymph nodes by sentinel lymph node (SLN) biopsy, the most important predictor of survival in patients with melanoma. The prognostic implications of TILs were re-evaluated in a large group of patients undergoing SLN biopsy at our institution. Patients and Methods All patients who underwent SLN mapping for primary cutaneous melanoma between January 1996 and July 2005 were evaluated. Univariate and multivariate analyses were performed to assess factors that predict SLN positivity and survival. Factors analyzed included Breslow thickness, ulceration, anatomic site, sex, Clark level, age, mitotic rate, and the presence (brisk or nonbrisk) or absence of TIL. Results Eight hundred eighty-seven patients underwent SLN mapping, and a SLN was identified in 875 patients (98.8%). The SLN was positive for tumor in 156 patients (17.6%). Multivariate analysis revealed that only Breslow thickness (P < .0001), ulceration (P = .0004), male sex (P = .03), and absent TILs (P = .0003) were independently predictive of the presence of SLN metastases. In melanomas with a brisk TIL infiltrate, the probability of a positive SLN was 3.9% as compared with 26.2% for melanomas in which TILs were absent. TILs were not an independent predictive factor for survival. Conclusion The absence of TILs, together with increasing Breslow thickness, presence of ulceration and male sex, predicts SLN metastasis in patients undergoing SLN biopsy for primary cutaneous melanoma.

The Prognostic Significance of Nonsentinel Lymph Node Metastasis in Melanoma

2010 ◽  
Vol 17 (12) ◽  
pp. 3330-3335 ◽  
Author(s):  
Russell E. Brown ◽  
Merrick I. Ross ◽  
Michael J. Edwards ◽  
R. Dirk Noyes ◽  
Douglas S. Reintgen ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Prognostic Significance ◽  
Node Metastasis ◽  
Nonsentinel Lymph Node

Prognostic value of size of lymph node metastases in patients with cutaneous melanoma.

1995 ◽  
Vol 13 (9) ◽  
pp. 2361-2368 ◽  
Author(s):  
A C Buzaid ◽  
L A Tinoco ◽  
D Jendiroba ◽  
Z N Tu ◽  
J J Lee ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Lymph Node ◽  
Cutaneous Melanoma ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Staging System ◽  
Nodal Metastases ◽  
Eligibility Criteria ◽  
Nodal Size

PURPOSE To determine the prognostic significance of the size of the lymph node mass as measured by physical examination (PE) and of the size of the largest node measured by pathologic analysis (path) in patients with cutaneous melanoma and nodal metastases. PATIENTS AND METHODS The medical records of all patients with nodal metastases seen at The University of Texas M.D. Anderson Cancer Center from January 1, 1973 to December 31, 1989 were reviewed. Patient eligibility criteria included the following: (1) availability of data describing the nodal size either by PE or by path and the number of positive nodes; (2) no history of preoperative chemotherapy or radiotherapy; and (3) no history or presence of in-transit, satellite, local, or distant metastases. Eleven variables, including largest diameter of the nodal mass by PE and diameter of the largest node by path, were examined as potential prognostic factors for disease-free survival (DFS) and overall survival (OS). RESULTS Of 800 patients evaluated, 442 met the eligibility criteria and are the subjects of this study. In the univariate analysis, size of the nodal mass by PE was marginally significant for survival as a continuous variable (P = .045), but not as a categorical variable using a cutoff size of < or = 3 or more than 3 cm as indicated by the American Joint Committee on Cancer (AJCC) staging system (P = .61). Size of the largest node by path was not significant for survival. In the multivariate analysis, only the number of positive nodes (P < .001), age (P < .001), and tumor thickness (P < .001) were significant for survival. CONCLUSION Size of the nodal mass by PE and size of the largest node by path are not useful prognostic factors for survival and should be eliminated from the current staging system. More powerful and well-established prognostic factors, such as the number of positive nodes, should be considered for inclusion in staging.

scholarly journals Superficial and deep lymph node dissection for stage III cutaneous melanoma: clinical outcome and prognostic factors

2013 ◽  
Vol 11 (1) ◽  
pp. 36 ◽  
Author(s):  
Nicola Mozzillo ◽  
Corrado Caracò ◽  
Ugo Marone ◽  
Gianluca Di Monta ◽  
Anna Crispo ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Lymph Node ◽  
Clinical Outcome ◽  
Lymph Node Dissection ◽  
Cutaneous Melanoma ◽  
Stage Iii ◽  
Node Dissection

scholarly journals The sentinel node invasion level (SNIL) as a prognostic parameter in melanoma

2021 ◽  
Author(s):  
Lutz Kretschmer ◽  
Christina Mitteldorf ◽  
Simin Hellriegel ◽  
Andreas Leha ◽  
Alexander Fichtner ◽  
...  
Keyword(s):  
Lymph Node ◽  
Prognostic Significance ◽  
Tumor Burden ◽  
Recurrence Rates ◽  
Cox Models ◽  
Nodal Basin ◽  
Lymph Vessels ◽  
Kaplan Meier ◽  
Metastasis Patterns ◽  
Transverse Sinuses

AbstractSentinel lymph node (SN) tumor burden is becoming increasingly important and is likely to be included in future N classifications in melanoma. Our aim was to investigate the prognostic significance of melanoma infiltration of various anatomically defined lymph node substructures. This retrospective cohort study included 1250 consecutive patients with SN biopsy. The pathology protocol required description of metastatic infiltration of each of the following lymph node substructures: intracapsular lymph vessels, subcapsular and transverse sinuses, cortex, paracortex, medulla, and capsule. Within the SN with the highest tumor burden, the SN invasion level (SNIL) was defined as follows: SNIL 1 = melanoma cells confined to intracapsular lymph vessels, subcapsular or transverse sinuses; SNIL 2 = melanoma infiltrating the cortex or paracortex; SNIL 3 = melanoma infiltrating the medulla or capsule. We classified 338 SN-positive patients according to the non-metric SNIL. Using Kaplan–Meier estimates and Cox models, recurrence-free survival (RFS), melanoma-specific survival (MSS) and nodal basin recurrence rates were analyzed. The median follow-up time was 75 months. The SNIL divided the SN-positive population into three groups with significantly different RFS, MSS, and nodal basin recurrence probabilities. The MSS of patients with SNIL 1 was virtually identical to that of SN-negative patients, whereas outgrowth of the metastasis from the parenchyma into the fibrous capsule or the medulla of the lymph node indicated a very poor prognosis. Thus, the SNIL may help to better assess the benefit-risk ratio of adjuvant therapies in patients with different SN metastasis patterns.

scholarly journals CCL20/TNF/VEGFA Cytokine Secretory Phenotype of Tumor-Associated Macrophages Is a Negative Prognostic Factor in Cutaneous Melanoma

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 3943
Author(s):  
Alba Gutiérrez-Seijo ◽  
Elena García-Martínez ◽  
Celia Barrio-Alonso ◽  
Miriam Pareja-Malagón ◽  
Alejandra Acosta-Ocampo ◽  
...  
Keyword(s):  
Cutaneous Melanoma ◽  
Large Fraction ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Rna Seq ◽  
Primary Cutaneous Melanoma ◽  
Kaplan Meier ◽  
Intracellular Cytokines ◽  
Negative Prognostic Factor

TAMs constitute a large fraction of infiltrating immune cells in melanoma tissues, but their significance for clinical outcomes remains unclear. We explored diverse TAM parameters in clinically relevant primary cutaneous melanoma samples, including density, location, size, and polarization marker expression; in addition, because cytokine production is a hallmark of macrophages function, we measured CCL20, TNF, and VEGFA intracellular cytokines by single-cell multiparametric confocal microscopy. The Kaplan–Meier method was used to analyze correlation with melanoma-specific disease-free survival and overall survival. No significant correlations with clinical parameters were observed for TAM density, morphology, or location. Significantly, higher contents of the intracellular cytokines CCL20, TNF, and VEGFA were quantified in TAMs infiltrating metastasizing compared to non-metastasizing skin primary melanomas (p < 0.001). To mechanistically explore cytokine up-regulation, we performed in vitro studies with melanoma-conditioned macrophages, using RNA-seq to explore involved pathways and specific inhibitors. We show that p53 and NF-κB coregulate CCL20, TNF, and VEGFA in melanoma-conditioned macrophages. These results delineate a clinically relevant pro-oncogenic cytokine profile of TAMs with prognostic significance in primary melanomas and point to the combined therapeutic targeting of NF-kB/p53 pathways to control the deviation of TAMs in melanoma.

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