Clinicopathological predictors of recurrence in nodular and superficial spreading cutaneous melanoma: a multivariate analysis of 214 cases

Journal of Translational Medicine

Research

Giovanni Ghigliotti¹  Maria Ausilia Manganoni²  Stefano Cavicchini³  Vincenzo De Giorgi⁴  Mauro Alaibac⁵  Pietro Rubegni⁶  Paola Queirolo⁷  Pietro Quaglino⁸  Stefano Astorino⁹  Maria T. Corradin^1,10  Maria A. Pizzichetta^1,11  Daniela Massi^1,12  Fabrizio Ayala^1,13  Serena Magi^1,14  Laura Mazzoni^1,14  Ignazio Stanganelli^1,14  Giuseppe Palmieri^1,15  Renato Talamini^1,16  Diego Serraino^1,16  Mario Mandalà^1,17 

[1] Clinic of Dermatology, IRCCS San Martino-IST, Genoa, Italy;Department of Dermatology, ASST degli Spedali Civili di Brescia, Brescia, Italy;Department of Dermatology, Fondazione Ospedale Maggiore Policlinico IRCCS, Milan, Italy;Department of Dermatology, University of Florence, Florence, Italy;Department of Dermatology, University of Padova, Padua, Italy;Department of Dermatology, University of Siena, Siena, Italy;Department of Medical Oncology, National Institute for Cancer Research, IRCCS San Martino, Genoa, Italy;Dermatologic Clinic, Dept Medical Sciences, University of Torino, Turin, Italy;Division of Dermatology, Celio Hospital, Rome, Italy;Division of Dermatology, Pordenone Hospital, Pordenone, Italy;Division of Oncology B, CRO Aviano National Cancer Institute, Via Franco Gallini 2, 33081, Aviano, Italy;Division of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy;National Cancer Institute, “Fondazione G. Pascale”-IRCCS, Naples, Italy;Skin Cancer Unit, Istituto Tumori Romagna (IRST), Meldola, Italy;Department of Dermatology, University of Parma, Parma, Italy;Unit of Cancer Genetics, Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Sassari, Italy;Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, Aviano, Italy;Unit of Medical Oncology, Papa Giovanni XXIII Hospital, Bergamo, Italy;

关键词: Nodular melanoma;    Superficial spreading melanoma;    Prognostic indicators;    Recurrence;   

DOI  :  10.1186/s12967-017-1332-3

 received in 2017-07-24, accepted in 2017-10-27,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundNodular melanoma (NM) accounts for most thick melanomas and because of their frequent association with ulceration, fast growth rate and high mitotic rate, contribute substantially to melanoma-related mortality. In a multicentric series of 214 primary melanomas including 96 NM and 118 superficial spreading melanoma (SSM), histopathological features were examined with the aim to identify clinicopathological predictors of recurrence.MethodsAll consecutive cases of histopathologically diagnosed primary invasive SSM and NM during the period 2005–2010, were retrieved from the 12 participating Italian Melanoma Intergroup (IMI) centers. Each center provided clinico-pathological data such as gender, age at diagnosis, anatomical site, histopathological conventional parameters, date of excision and first melanoma recurrence.ResultsResults showed that NM subtype was significantly associated with Breslow thickness (BT) at multivariate analysis: [BT 1.01–2 mm (OR 7.22; 95% CI 2.73–19.05), BT 2.01–4 mm (OR 7.04; 95% CI 2.54–19.56), and BT > 4 mm (OR 51.78; 95% CI 5.65–474.86) (p < 0.0001)]. Furthermore, mitotic rate (MR) was significantly correlated with NM histotype: [(MR 3–5 mitoses/mm2 (OR 2.62; 95% CI 1.01–6.83) and MR > 5 mitoses/mm2 (OR 4.87; 95% CI 1.77–13.40) (p = 0.002)]. The risk of recurrence was not significantly associated with NM histotype while BT [BT 1.01–2.00 mm (HR 1.55; 95% CI 0.51–4.71), BT 2.01–4.00 mm (HR 2.42; 95% CI 0.89–6.54), BT > 4.00 mm. (HR 3.13; 95% CI 0.95–10.28) (p = 0.05)], mitotic rate [MR > 2 mitoses/mm2 (HR 2.34; 95% CI, 1.11–4.97) (p = 0.03)] and the positivity of lymph node sentinel biopsy (SNLB) (HR 2.60; 95% CI 1.19–5.68) (p = 0.007) were significantly associated with an increased risk of recurrence at multivariate analysis.ConclusionsWe found that NM subtype was significantly associated with higher BT and MR but it was not a prognostic factor since it did not significantly correlate with melanoma recurrence rate. Conversely, increased BT and MR as well as SNLB positivity were significantly associated with a higher risk of melanoma recurrence.

【 授权许可】

CC BY   
© The Author(s) 2017