LymphedemaV1, Main, Exploration, bibRecord, 004A38

Thick primary melanoma has a heterogeneous tumor biology: an institutional series

Identifieur interne : 004A38 ( Main/Exploration ); précédent : 004A37; suivant : 004A39

Thick primary melanoma has a heterogeneous tumor biology: an institutional series

Auteurs : Ari-Nareg Meguerditchian [Canada] ; Kobby Asubonteng [États-Unis] ; Calvin Young [États-Unis] ; Bethany Lema [États-Unis] ; Gregory Wilding [États-Unis] ; John M. Kane Iii [États-Unis]

Source :

World Journal of Surgical Oncology [ 1477-7819 ] ; 2011.

RBID : PMC:3090362

Abstract

Background

Thick melanomas (TM) ≥4 mm have a high risk for nodal and distant metastases. Optimal surgical management, prognostic significance of sentinel node biopsy (SLNB), and benefits of interferon (IFN) for these patients are unclear. As a continuum of increasing tumor thickness is placed into a single TM group, differences in biologic and clinical behavior may be lost. The purpose of this study was to better characterize the diverse biology in TM, including the value of increasing thickness and nodal status information, potentially identifying high risk TM subgroups that may warrant more aggressive treatment/follow up.

Methods

155 consecutive TM patients treated at a single institution between 1971 and 2007 were retrospectively reviewed. Patient, disease and treatment features were analyzed with respect to disease-free (DFS) and overall survival (OS).

Results

Median patient age was 66 years and 68% of patients were men. The trunk was the most common TM location (35%), followed by the head and neck (29%) and lower extremities (20%). Median thickness was 6 mm and 61% were ulcerated. 6% patients had stage IV disease, 12% had clinical nodal metastases. Clinically negative lymph node basins were treated by observation (22 patients - 15.4%), elective lymph node dissection (ELND) (24 patients - 17.6%) or SLNB (91 patients - 67%). 75% of ELND's and 53% of SLNB's were positive. Completion node dissection was performed in 38 SLNB+ patients and 22% had additional positive nodes. 17% of the study patients received IFN. At median follow up of 26 months, 5 year DFS and OS were 42% and 43.6%. For SLNB positive vs negative, median DFS were 22 vs 111 months (p = 0.006) and median OS were 41 vs 111 months (p = 0.006). When stratified by tumor thickness ≤ vs > 6 mm, 5 year DFS was 58.3% vs 20% (p < 0.0001) and OS was 62% vs 20% (P < 0.0001). IFN had no impact on DFS or OS (p = 0.98 and 0.8 respectively).

Conclusion

Within the high risk group of patients with TM, cases with tumor thickness > 6 mm or a positive SLNB had a significantly worse DFS and OS (p < .0001, <.0001 and .006, .006).

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3090362

DOI: 10.1186/1477-7819-9-40
PubMed: 21492474
PubMed Central: 3090362

Affiliations:

Le document en format XML

<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Thick primary melanoma has a heterogeneous tumor biology: an institutional series</title>
<author><name sortKey="Meguerditchian, Ari Nareg" sort="Meguerditchian, Ari Nareg" uniqKey="Meguerditchian A" first="Ari-Nareg" last="Meguerditchian">Ari-Nareg Meguerditchian</name>
<affiliation wicri:level="4"><nlm:aff id="I1">Department of Surgery, McGill University, Montreal, QC H3A 1A1, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Department of Surgery, McGill University, Montreal, QC H3A 1A1</wicri:regionArea>
<orgName type="university">Université McGill</orgName>
<placeName><settlement type="city">Montréal</settlement>
<region type="state">Québec</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Asubonteng, Kobby" sort="Asubonteng, Kobby" uniqKey="Asubonteng K" first="Kobby" last="Asubonteng">Kobby Asubonteng</name>
<affiliation wicri:level="1"><nlm:aff id="I2">Department of Biostatistics, State University of New York, Buffalo, NY, 14214, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Biostatistics, State University of New York, Buffalo, NY, 14214</wicri:regionArea>
<wicri:noRegion>14214</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Young, Calvin" sort="Young, Calvin" uniqKey="Young C" first="Calvin" last="Young">Calvin Young</name>
<affiliation wicri:level="1"><nlm:aff id="I3">School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, 14214, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, 14214</wicri:regionArea>
<wicri:noRegion>14214</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Lema, Bethany" sort="Lema, Bethany" uniqKey="Lema B" first="Bethany" last="Lema">Bethany Lema</name>
<affiliation wicri:level="1"><nlm:aff id="I3">School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, 14214, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, 14214</wicri:regionArea>
<wicri:noRegion>14214</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Wilding, Gregory" sort="Wilding, Gregory" uniqKey="Wilding G" first="Gregory" last="Wilding">Gregory Wilding</name>
<affiliation wicri:level="1"><nlm:aff id="I2">Department of Biostatistics, State University of New York, Buffalo, NY, 14214, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Biostatistics, State University of New York, Buffalo, NY, 14214</wicri:regionArea>
<wicri:noRegion>14214</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kane Iii, John M" sort="Kane Iii, John M" uniqKey="Kane Iii J" first="John M" last="Kane Iii">John M. Kane Iii</name>
<affiliation wicri:level="1"><nlm:aff id="I4">Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263</wicri:regionArea>
<wicri:noRegion>NY 14263</wicri:noRegion>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">21492474</idno>
<idno type="pmc">3090362</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3090362</idno>
<idno type="RBID">PMC:3090362</idno>
<idno type="doi">10.1186/1477-7819-9-40</idno>
<date when="2011">2011</date>
<idno type="wicri:Area/Pmc/Corpus">004669</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004669</idno>
<idno type="wicri:Area/Pmc/Curation">004668</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">004668</idno>
<idno type="wicri:Area/Pmc/Checkpoint">002C66</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002C66</idno>
<idno type="wicri:Area/Ncbi/Merge">004280</idno>
<idno type="wicri:Area/Ncbi/Curation">004280</idno>
<idno type="wicri:Area/Ncbi/Checkpoint">004280</idno>
<idno type="wicri:Area/Main/Merge">004A70</idno>
<idno type="wicri:Area/Main/Curation">004A38</idno>
<idno type="wicri:Area/Main/Exploration">004A38</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Thick primary melanoma has a heterogeneous tumor biology: an institutional series</title>
<author><name sortKey="Meguerditchian, Ari Nareg" sort="Meguerditchian, Ari Nareg" uniqKey="Meguerditchian A" first="Ari-Nareg" last="Meguerditchian">Ari-Nareg Meguerditchian</name>
<affiliation wicri:level="4"><nlm:aff id="I1">Department of Surgery, McGill University, Montreal, QC H3A 1A1, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Department of Surgery, McGill University, Montreal, QC H3A 1A1</wicri:regionArea>
<orgName type="university">Université McGill</orgName>
<placeName><settlement type="city">Montréal</settlement>
<region type="state">Québec</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Asubonteng, Kobby" sort="Asubonteng, Kobby" uniqKey="Asubonteng K" first="Kobby" last="Asubonteng">Kobby Asubonteng</name>
<affiliation wicri:level="1"><nlm:aff id="I2">Department of Biostatistics, State University of New York, Buffalo, NY, 14214, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Biostatistics, State University of New York, Buffalo, NY, 14214</wicri:regionArea>
<wicri:noRegion>14214</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Young, Calvin" sort="Young, Calvin" uniqKey="Young C" first="Calvin" last="Young">Calvin Young</name>
<affiliation wicri:level="1"><nlm:aff id="I3">School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, 14214, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, 14214</wicri:regionArea>
<wicri:noRegion>14214</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Lema, Bethany" sort="Lema, Bethany" uniqKey="Lema B" first="Bethany" last="Lema">Bethany Lema</name>
<affiliation wicri:level="1"><nlm:aff id="I3">School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, 14214, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, 14214</wicri:regionArea>
<wicri:noRegion>14214</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Wilding, Gregory" sort="Wilding, Gregory" uniqKey="Wilding G" first="Gregory" last="Wilding">Gregory Wilding</name>
<affiliation wicri:level="1"><nlm:aff id="I2">Department of Biostatistics, State University of New York, Buffalo, NY, 14214, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Biostatistics, State University of New York, Buffalo, NY, 14214</wicri:regionArea>
<wicri:noRegion>14214</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kane Iii, John M" sort="Kane Iii, John M" uniqKey="Kane Iii J" first="John M" last="Kane Iii">John M. Kane Iii</name>
<affiliation wicri:level="1"><nlm:aff id="I4">Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263</wicri:regionArea>
<wicri:noRegion>NY 14263</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">World Journal of Surgical Oncology</title>
<idno type="eISSN">1477-7819</idno>
<imprint><date when="2011">2011</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Thick melanomas (TM) ≥4 mm have a high risk for nodal and distant metastases. Optimal surgical management, prognostic significance of sentinel node biopsy (SLNB), and benefits of interferon (IFN) for these patients are unclear. As a continuum of increasing tumor thickness is placed into a single TM group, differences in biologic and clinical behavior may be lost. The purpose of this study was to better characterize the diverse biology in TM, including the value of increasing thickness and nodal status information, potentially identifying high risk TM subgroups that may warrant more aggressive treatment/follow up.</p>
</sec>
<sec><title>Methods</title>
<p>155 consecutive TM patients treated at a single institution between 1971 and 2007 were retrospectively reviewed. Patient, disease and treatment features were analyzed with respect to disease-free (DFS) and overall survival (OS).</p>
</sec>
<sec><title>Results</title>
<p>Median patient age was 66 years and 68% of patients were men. The trunk was the most common TM location (35%), followed by the head and neck (29%) and lower extremities (20%). Median thickness was 6 mm and 61% were ulcerated. 6% patients had stage IV disease, 12% had clinical nodal metastases. Clinically negative lymph node basins were treated by observation (22 patients - 15.4%), elective lymph node dissection (ELND) (24 patients - 17.6%) or SLNB (91 patients - 67%). 75% of ELND's and 53% of SLNB's were positive. Completion node dissection was performed in 38 SLNB+ patients and 22% had additional positive nodes. 17% of the study patients received IFN. At median follow up of 26 months, 5 year DFS and OS were 42% and 43.6%. For SLNB positive vs negative, median DFS were 22 vs 111 months (p = 0.006) and median OS were 41 vs 111 months (p = 0.006). When stratified by tumor thickness ≤ vs > 6 mm, 5 year DFS was 58.3% vs 20% (p < 0.0001) and OS was 62% vs 20% (P < 0.0001). IFN had no impact on DFS or OS (p = 0.98 and 0.8 respectively).</p>
</sec>
<sec><title>Conclusion</title>
<p>Within the high risk group of patients with TM, cases with tumor thickness > 6 mm or a positive SLNB had a significantly worse DFS and OS (p < .0001, <.0001 and .006, .006).</p>
</sec>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Linos, E" uniqKey="Linos E">E Linos</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Coit, D" uniqKey="Coit D">D Coit</name>
</author>
<author><name sortKey="Sauven, P" uniqKey="Sauven P">P Sauven</name>
</author>
<author><name sortKey="Brennan, M" uniqKey="Brennan M">M Brennan </name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Balch, Cm" uniqKey="Balch C">CM Balch</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Balch, Cm" uniqKey="Balch C">CM Balch</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Balch, Cm" uniqKey="Balch C">CM Balch</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Balch, Cm" uniqKey="Balch C">CM Balch</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Cascinelli, N" uniqKey="Cascinelli N">N Cascinelli</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Schneebaum, S" uniqKey="Schneebaum S">S Schneebaum</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Sim, Fh" uniqKey="Sim F">FH Sim</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Cherpelis, Bs" uniqKey="Cherpelis B">BS Cherpelis</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Essner, R" uniqKey="Essner R">R Essner</name>
</author>
<author><name sortKey="Morton, Dl" uniqKey="Morton D">DL Morton</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Gershenwald, Je" uniqKey="Gershenwald J">JE Gershenwald</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Carlson, Gw" uniqKey="Carlson G">GW Carlson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ferrone, Cr" uniqKey="Ferrone C">CR Ferrone</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Vermeeren, L" uniqKey="Vermeeren L">L Vermeeren</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Cecchi, R" uniqKey="Cecchi R">R Cecchi</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ascierto, Pa" uniqKey="Ascierto P">PA Ascierto</name>
</author>
<author><name sortKey="Kirkwood, Jm" uniqKey="Kirkwood J">JM Kirkwood</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Hancock, Bw" uniqKey="Hancock B">BW Hancock</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kirkwood, Jm" uniqKey="Kirkwood J">JM Kirkwood</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kirkwood, Jm" uniqKey="Kirkwood J">JM Kirkwood</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kirkwood, Jm" uniqKey="Kirkwood J">JM Kirkwood</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Balch, Cm" uniqKey="Balch C">CM Balch</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Karakousis, Cp" uniqKey="Karakousis C">CP Karakousis</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Coit, Dg" uniqKey="Coit D">DG Coit</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kim, Sh" uniqKey="Kim S">SH Kim</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Balch, Cm" uniqKey="Balch C">CM Balch</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Morton, Dl" uniqKey="Morton D">DL Morton</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Morton, Dl" uniqKey="Morton D">DL Morton</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Morton, Dl" uniqKey="Morton D">DL Morton</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Mcmasters, Km" uniqKey="Mcmasters K">KM McMasters</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Scoggins, Cr" uniqKey="Scoggins C">CR Scoggins</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Gajdos, C" uniqKey="Gajdos C">C Gajdos</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<affiliations><list><country><li>Canada</li>
<li>États-Unis</li>
</country>
<region><li>Québec</li>
</region>
<settlement><li>Montréal</li>
</settlement>
<orgName><li>Université McGill</li>
</orgName>
</list>
<tree><country name="Canada"><region name="Québec"><name sortKey="Meguerditchian, Ari Nareg" sort="Meguerditchian, Ari Nareg" uniqKey="Meguerditchian A" first="Ari-Nareg" last="Meguerditchian">Ari-Nareg Meguerditchian</name>
</region>
</country>
<country name="États-Unis"><noRegion><name sortKey="Asubonteng, Kobby" sort="Asubonteng, Kobby" uniqKey="Asubonteng K" first="Kobby" last="Asubonteng">Kobby Asubonteng</name>
</noRegion>
<name sortKey="Kane Iii, John M" sort="Kane Iii, John M" uniqKey="Kane Iii J" first="John M" last="Kane Iii">John M. Kane Iii</name>
<name sortKey="Lema, Bethany" sort="Lema, Bethany" uniqKey="Lema B" first="Bethany" last="Lema">Bethany Lema</name>
<name sortKey="Wilding, Gregory" sort="Wilding, Gregory" uniqKey="Wilding G" first="Gregory" last="Wilding">Gregory Wilding</name>
<name sortKey="Young, Calvin" sort="Young, Calvin" uniqKey="Young C" first="Calvin" last="Young">Calvin Young</name>
</country>
</tree>
</affiliations>
</record>

Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Main/Exploration

HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 004A38 | SxmlIndent | more

HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 004A38 | SxmlIndent | more

Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Wicri/Sante
   |area=    LymphedemaV1
   |flux=    Main
   |étape=   Exploration
   |type=    RBID
   |clé=     PMC:3090362
   |texte=   Thick primary melanoma has a heterogeneous tumor biology: an institutional series
}}

Pour générer des pages wiki

HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i   -Sk "pubmed:21492474" \
       | HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd   \
       | NlmPubMed2Wicri -a LymphedemaV1

This area was generated with Dilib version V0.6.31.
Data generation: Sat Nov 4 17:40:35 2017. Site generation: Tue Feb 13 16:42:16 2024

Serveur d'exploration sur le lymphœdème

Thick primary melanoma has a heterogeneous tumor biology: an institutional series

Thick primary melanoma has a heterogeneous tumor biology: an institutional series

Source :

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki

	Serveur d'exploration sur le lymphœdème
	Attention, ce site est en cours de développement ! Attention, site généré par des moyens informatiques à partir de corpus bruts. Les informations ne sont donc pas validées.