Partial regression of primary cutaneous melanoma - Is there an association with sub-clinical sentinel lymph node metastasis?

被引:48
作者
Fontaine, D
Parkhill, W
Greer, W
Walsh, N
机构
[1] Queen Elizabeth II Hlth Sci Ctr, Div Anat Pathol, Dept Pathol, Halifax, NS B3H 1V8, Canada
[2] Queen Elizabeth II Hlth Sci Ctr, Dept Surg, Halifax, NS B3H 1V8, Canada
[3] Dalhousie Univ, Halifax, NS, Canada
关键词
prognostic factor; regression of melanoma; sentinel lymph node metastasis;
D O I
10.1097/00000372-200310000-00002
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Whether partial regression of a primary melanoma has an adverse impact on prognosis is controversial. As an indirect mechanism of addressing this question we drew a correlation between the histopathological characteristics of 107 cutaneous melanomas and the presence of sub-clinical metastasis in corresponding sentinel lymph nodes. Partial regression of the primary tumor, defined as focal replacement of the lesion by a scar, unrelated to a previous biopsy, was observed in 20 (19%) cases in the group as a whole. Excluding cases in which an accurate Breslow thickness of the primary melanoma could not be established and/or the presence of a capsular nevus was detected in the sentinel node, a total of 97 remained. Seventeen cases (Breslow thickness 0.63-9.7; mean 2.4 mm) showed partial regression and 80 (Breslow thickness 0.25-7.00; mean 1.8 mm) were devoid of regression. Of the 17 cases with regression 5 (29%) had nodal metastasis (by histopathology and/or molecular analysis) and of the 80 cases without regression 23 (29%) had nodal metastasis (by one or both evaluations). Our data reveals no association between partial regression of the primary melanoma and sentinel node involvement by the disease. The Breslow thickness proved to be the only significant independent variable related to nodal metastasis. Of interest, ulceration of the primary lesion was significantly associated with nodal disease on univariate, but not on multivariate, analysis. While acknowledging that the cohort size may lack the statistical power to demonstrate subtle associations, our data supports the known relevance of tumor thickness and ulceration to regional lymph node metastasis and thereby, to outcome of melanoma in its early stages, but fails to support a similar role for partial regression.
引用
收藏
页码:371 / 376
页数:6
相关论文
共 28 条
  • [1] Prognostic factors analysis of 17,600 melanoma patients: Validation of the American Joint Committee on Cancer melanoma staging system
    Balch, CM
    Soong, SJ
    Gershenwald, JE
    Thompson, JF
    Reintgen, DS
    Cascinelli, N
    Urist, M
    McMasters, KM
    Ross, MI
    Kirkwood, JM
    Atkins, MB
    Thompson, JA
    Coit, DG
    Byrd, D
    Desmond, R
    Zhang, YT
    Liu, PY
    Lyman, GH
    Morabito, A
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2001, 19 (16) : 3622 - 3634
  • [2] BARNHILL RL, 1995, PATHOLOGY MELANOCYTI, P269
  • [3] HISTOLOGICAL REGRESSION IN PRIMARY CUTANEOUS MELANOMA - RECOGNITION, PREVALENCE AND SIGNIFICANCE
    BLESSING, K
    MCLAREN, KM
    [J]. HISTOPATHOLOGY, 1992, 20 (04) : 315 - 322
  • [4] THIN MALIGNANT MELANOMAS (LESS-THAN-1.5 MM) WITH METASTASIS - A HISTOLOGICAL STUDY AND SURVIVAL ANALYSIS
    BLESSING, K
    MCLAREN, KM
    MCLEAN, A
    DAVIDSON, P
    [J]. HISTOPATHOLOGY, 1990, 17 (05) : 389 - 395
  • [5] EXPERIENCE OF THIN CUTANEOUS MELANOMAS (LESS-THAN 0.76MM AND LESS-THAN 0.85MM THICK) IN A LARGE PLASTIC-SURGERY UNIT - A 5 TO 17 YEAR FOLLOW-UP
    BRIGGS, JC
    IBRAHIM, NBN
    HASTINGS, AG
    GRIFFITHS, RW
    [J]. BRITISH JOURNAL OF PLASTIC SURGERY, 1984, 37 (04): : 501 - 506
  • [6] Busam KJ, 2001, AM J CLIN PATHOL, V115, P856
  • [7] MODEL PREDICTING SURVIVAL IN STAGE-I MELANOMA BASED ON TUMOR PROGRESSION
    CLARK, WH
    ELDER, DE
    GUERRY, D
    BRAITMAN, LE
    TROCK, BJ
    SCHULTZ, D
    SYNNESTVEDT, M
    HALPERN, AC
    [J]. JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1989, 81 (24): : 1893 - 1904
  • [8] REGRESSION IN THIN MALIGNANT-MELANOMA - MICROSCOPIC DIAGNOSIS AND PROGNOSTIC IMPORTANCE
    COOPER, PH
    WANEBO, HJ
    HAGAR, RW
    [J]. ARCHIVES OF DERMATOLOGY, 1985, 121 (09) : 1127 - 1131
  • [9] Nevus cells in lymph nodes - An association with congenital cutaneous nevi
    Fontaine, D
    Parkhill, W
    Greer, W
    Walsh, N
    [J]. AMERICAN JOURNAL OF DERMATOPATHOLOGY, 2002, 24 (01) : 1 - 5
  • [10] GROMET M, 1978, CANCER, V48, P2282