Does mitotic rate predict sentinel lymph node metastasis or survival in patients with intermediate and thick melanoma?
Abstract Background The significance of mitotic rate (MR) in melanoma remains controversial. Methods In this retrospective analysis of a prospective randomized trial that included patients with melanoma of 1.0 mm or greater, all patients underwent wide excision and sentinel node (sentinel lymph node...
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| Veröffentlicht in: | The American journal of surgery 2010-12, Vol.200 (6), p.759-764 |
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| creator | Roach, Brent A., B.A Burton, Alison L., B.S Mays, Michael P., M.D Ginter, Brooke A., B.S Martin, Robert C.G., M.D., Ph.D Stromberg, Arnold J., Ph.D Hagendoorn, Lee, M.B.A McMasters, Kelly M., M.D., Ph.D Scoggins, Charles R., M.D., M.B.A |
| description | Abstract Background The significance of mitotic rate (MR) in melanoma remains controversial. Methods In this retrospective analysis of a prospective randomized trial that included patients with melanoma of 1.0 mm or greater, all patients underwent wide excision and sentinel node (sentinel lymph node [SLN]) biopsy. Univariate and multivariate analyses were performed to evaluate factors predictive of disease-free survival (DFS) and overall survival (OS). Results A total of 551 patients had MR reported. A cut-off point of 6 mitoses/mm2 best discriminated DFS and OS: 455 patients (82.6%) had MR less than 6/mm2 . SLN were tumor-positive in 14.7% of low MR versus 31.3% of high MR patients ( P = .0003). There were significant differences in DFS ( P = .0014) and OS ( P = .0002) between the 2 groups, however, MR failed to remain significant in the multivariate model. Conclusions MR is weakly predictive of SLN status but it is not an independent predictor of survival for melanomas 1.0 mm or thicker. |
| doi_str_mv | 10.1016/j.amjsurg.2010.07.037 |
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Methods In this retrospective analysis of a prospective randomized trial that included patients with melanoma of 1.0 mm or greater, all patients underwent wide excision and sentinel node (sentinel lymph node [SLN]) biopsy. Univariate and multivariate analyses were performed to evaluate factors predictive of disease-free survival (DFS) and overall survival (OS). Results A total of 551 patients had MR reported. A cut-off point of 6 mitoses/mm2 best discriminated DFS and OS: 455 patients (82.6%) had MR less than 6/mm2 . SLN were tumor-positive in 14.7% of low MR versus 31.3% of high MR patients ( P = .0003). There were significant differences in DFS ( P = .0014) and OS ( P = .0002) between the 2 groups, however, MR failed to remain significant in the multivariate model. Conclusions MR is weakly predictive of SLN status but it is not an independent predictor of survival for melanomas 1.0 mm or thicker.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2010.07.037</identifier><identifier>PMID: 21146017</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Biopsy ; Dermatology ; Disease-Free Survival ; Female ; General aspects ; Hematologic and hematopoietic diseases ; Humans ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Lymph ; Lymph nodes ; Lymphatic Metastasis ; Lymphatic system ; Male ; Medical prognosis ; Medical sciences ; Melanoma ; Melanoma - mortality ; Melanoma - pathology ; Metastases ; Metastasis ; Middle Aged ; Mitosis ; Mitotic Index ; Mitotic rate ; Multivariate analysis ; Patients ; Randomized Controlled Trials as Topic ; Sentinel lymph node ; Sentinel Lymph Node Biopsy ; Skin cancer ; Skin Neoplasms - mortality ; Skin Neoplasms - pathology ; Surgery ; Survival ; Survival Rate ; Tumors ; Tumors of the skin and soft tissue. Premalignant lesions ; Variables ; Young Adult</subject><ispartof>The American journal of surgery, 2010-12, Vol.200 (6), p.759-764</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2010 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Dec 1, 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-6dc874baef9d1af7bcedfef6da62aa9e2835d98dfdcfb923f82ee2bdc7e0de6f3</citedby><cites>FETCH-LOGICAL-c477t-6dc874baef9d1af7bcedfef6da62aa9e2835d98dfdcfb923f82ee2bdc7e0de6f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002961010005726$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,776,780,785,786,3537,23909,23910,25118,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23752371$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21146017$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Roach, Brent A., B.A</creatorcontrib><creatorcontrib>Burton, Alison L., B.S</creatorcontrib><creatorcontrib>Mays, Michael P., M.D</creatorcontrib><creatorcontrib>Ginter, Brooke A., B.S</creatorcontrib><creatorcontrib>Martin, Robert C.G., M.D., Ph.D</creatorcontrib><creatorcontrib>Stromberg, Arnold J., Ph.D</creatorcontrib><creatorcontrib>Hagendoorn, Lee, M.B.A</creatorcontrib><creatorcontrib>McMasters, Kelly M., M.D., Ph.D</creatorcontrib><creatorcontrib>Scoggins, Charles R., M.D., M.B.A</creatorcontrib><title>Does mitotic rate predict sentinel lymph node metastasis or survival in patients with intermediate and thick melanoma?</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract Background The significance of mitotic rate (MR) in melanoma remains controversial. Methods In this retrospective analysis of a prospective randomized trial that included patients with melanoma of 1.0 mm or greater, all patients underwent wide excision and sentinel node (sentinel lymph node [SLN]) biopsy. Univariate and multivariate analyses were performed to evaluate factors predictive of disease-free survival (DFS) and overall survival (OS). Results A total of 551 patients had MR reported. A cut-off point of 6 mitoses/mm2 best discriminated DFS and OS: 455 patients (82.6%) had MR less than 6/mm2 . SLN were tumor-positive in 14.7% of low MR versus 31.3% of high MR patients ( P = .0003). There were significant differences in DFS ( P = .0014) and OS ( P = .0002) between the 2 groups, however, MR failed to remain significant in the multivariate model. Conclusions MR is weakly predictive of SLN status but it is not an independent predictor of survival for melanomas 1.0 mm or thicker.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>Dermatology</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>General aspects</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Humans</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Lymph</subject><subject>Lymph nodes</subject><subject>Lymphatic Metastasis</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Melanoma</subject><subject>Melanoma - mortality</subject><subject>Melanoma - pathology</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Mitosis</subject><subject>Mitotic Index</subject><subject>Mitotic rate</subject><subject>Multivariate analysis</subject><subject>Patients</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Sentinel lymph node</subject><subject>Sentinel Lymph Node Biopsy</subject><subject>Skin cancer</subject><subject>Skin Neoplasms - mortality</subject><subject>Skin Neoplasms - pathology</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Tumors</subject><subject>Tumors of the skin and soft tissue. Premalignant lesions</subject><subject>Variables</subject><subject>Young Adult</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkl2L1DAUhoMo7rj6E5SAiFcdk3TapDcusn7CghfqdUiTEyfdfpmkI_PvPWVGF_ZGSEkanvPm5H1DyHPOtpzx-k23NUOXlvhzKxjuMbllpXxANlzJpuBKlQ_JhjEmiqbm7II8SanDX8535WNyIXCuGZcbcng_QaJDyFMOlkaTgc4RXLCZJhhzGKGn_XGY93ScHNABskk4QqJTpHj8IRxMT8NIZ5MDFiT6O-Q9bmSIA-qsgmZ0NO-DvcXy3ozTYK6ekkfe9AmenedL8uPjh-_Xn4ubr5--XL-7KexOylzUziq5aw34xnHjZWvBefC1M7UwpgGhyso1ynlnfduI0isBIFpnJTAHtS8vyeuT7hynXwukrIeQLPTYBkxL0krwnSqVqJF8eY_spiWO2Jzmjah4IxtVIlWdKBunlCJ4PccwmHjUnOk1F93pcy56zUUzqTEXrHtxVl9atOVf1d8gEHh1BkyypvfRjDakO66UFX4cuasTB-jaIUDUyaLv6EuIYLN2U_hvK2_vKdg-jAEPvYUjpLtb6yQ009_WR7S-IY6LSqJTfwAoNMb4</recordid><startdate>20101201</startdate><enddate>20101201</enddate><creator>Roach, Brent A., B.A</creator><creator>Burton, Alison L., B.S</creator><creator>Mays, Michael P., M.D</creator><creator>Ginter, Brooke A., B.S</creator><creator>Martin, Robert C.G., M.D., Ph.D</creator><creator>Stromberg, Arnold J., Ph.D</creator><creator>Hagendoorn, Lee, M.B.A</creator><creator>McMasters, Kelly M., M.D., Ph.D</creator><creator>Scoggins, Charles R., M.D., M.B.A</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20101201</creationdate><title>Does mitotic rate predict sentinel lymph node metastasis or survival in patients with intermediate and thick melanoma?</title><author>Roach, Brent A., B.A ; Burton, Alison L., B.S ; Mays, Michael P., M.D ; Ginter, Brooke A., B.S ; Martin, Robert C.G., M.D., Ph.D ; Stromberg, Arnold J., Ph.D ; Hagendoorn, Lee, M.B.A ; McMasters, Kelly M., M.D., Ph.D ; Scoggins, Charles R., M.D., M.B.A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-6dc874baef9d1af7bcedfef6da62aa9e2835d98dfdcfb923f82ee2bdc7e0de6f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>Dermatology</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>General aspects</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Humans</topic><topic>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Lymph</topic><topic>Lymph nodes</topic><topic>Lymphatic Metastasis</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Melanoma</topic><topic>Melanoma - mortality</topic><topic>Melanoma - pathology</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Mitosis</topic><topic>Mitotic Index</topic><topic>Mitotic rate</topic><topic>Multivariate analysis</topic><topic>Patients</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Sentinel lymph node</topic><topic>Sentinel Lymph Node Biopsy</topic><topic>Skin cancer</topic><topic>Skin Neoplasms - mortality</topic><topic>Skin Neoplasms - pathology</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Tumors</topic><topic>Tumors of the skin and soft tissue. Premalignant lesions</topic><topic>Variables</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Roach, Brent A., B.A</creatorcontrib><creatorcontrib>Burton, Alison L., B.S</creatorcontrib><creatorcontrib>Mays, Michael P., M.D</creatorcontrib><creatorcontrib>Ginter, Brooke A., B.S</creatorcontrib><creatorcontrib>Martin, Robert C.G., M.D., Ph.D</creatorcontrib><creatorcontrib>Stromberg, Arnold J., Ph.D</creatorcontrib><creatorcontrib>Hagendoorn, Lee, M.B.A</creatorcontrib><creatorcontrib>McMasters, Kelly M., M.D., Ph.D</creatorcontrib><creatorcontrib>Scoggins, Charles R., M.D., M.B.A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Roach, Brent A., B.A</au><au>Burton, Alison L., B.S</au><au>Mays, Michael P., M.D</au><au>Ginter, Brooke A., B.S</au><au>Martin, Robert C.G., M.D., Ph.D</au><au>Stromberg, Arnold J., Ph.D</au><au>Hagendoorn, Lee, M.B.A</au><au>McMasters, Kelly M., M.D., Ph.D</au><au>Scoggins, Charles R., M.D., M.B.A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does mitotic rate predict sentinel lymph node metastasis or survival in patients with intermediate and thick melanoma?</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2010-12-01</date><risdate>2010</risdate><volume>200</volume><issue>6</issue><spage>759</spage><epage>764</epage><pages>759-764</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>Abstract Background The significance of mitotic rate (MR) in melanoma remains controversial. Methods In this retrospective analysis of a prospective randomized trial that included patients with melanoma of 1.0 mm or greater, all patients underwent wide excision and sentinel node (sentinel lymph node [SLN]) biopsy. Univariate and multivariate analyses were performed to evaluate factors predictive of disease-free survival (DFS) and overall survival (OS). Results A total of 551 patients had MR reported. A cut-off point of 6 mitoses/mm2 best discriminated DFS and OS: 455 patients (82.6%) had MR less than 6/mm2 . SLN were tumor-positive in 14.7% of low MR versus 31.3% of high MR patients ( P = .0003). There were significant differences in DFS ( P = .0014) and OS ( P = .0002) between the 2 groups, however, MR failed to remain significant in the multivariate model. Conclusions MR is weakly predictive of SLN status but it is not an independent predictor of survival for melanomas 1.0 mm or thicker.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21146017</pmid><doi>10.1016/j.amjsurg.2010.07.037</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Aged Biological and medical sciences Biopsy Dermatology Disease-Free Survival Female General aspects Hematologic and hematopoietic diseases Humans Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Lymph Lymph nodes Lymphatic Metastasis Lymphatic system Male Medical prognosis Medical sciences Melanoma Melanoma - mortality Melanoma - pathology Metastases Metastasis Middle Aged Mitosis Mitotic Index Mitotic rate Multivariate analysis Patients Randomized Controlled Trials as Topic Sentinel lymph node Sentinel Lymph Node Biopsy Skin cancer Skin Neoplasms - mortality Skin Neoplasms - pathology Surgery Survival Survival Rate Tumors Tumors of the skin and soft tissue. Premalignant lesions Variables Young Adult |
| title | Does mitotic rate predict sentinel lymph node metastasis or survival in patients with intermediate and thick melanoma? |
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