Absence of Tumor-Infiltrating Lymphocyte Is a Reproducible Predictive Factor for Sentinel Lymph Node Metastasis: A Multicenter Database Study by the Brazilian Melanoma Group
Identifieur interne : 000832 ( Pmc/Curation ); précédent : 000831; suivant : 000833Absence of Tumor-Infiltrating Lymphocyte Is a Reproducible Predictive Factor for Sentinel Lymph Node Metastasis: A Multicenter Database Study by the Brazilian Melanoma Group
Auteurs : João Pedreira Duprat [Brésil] ; Eduard René Brechtbülh [Brésil] ; Bianca Costa De Sá [Brésil] ; Mauro Enokihara [Brésil] ; Jose Humberto Fregnani [Brésil] ; Gilles Landman [Brésil] ; Marcus Maia [Brésil] ; Felice Riccardi [Brésil] ; Francisco Alberto Belfort [Brésil] ; Alberto Wainstein [Brésil] ; Luciana F. Moredo [Brésil] ; Higino Steck [Brésil] ; Miguel Brandão [Brésil] ; Marcelo Moreno [Brésil] ; Eduardo Miranda [Brésil] ; Ivan Dunshee De Oliveira Santos [Brésil]Source :
- PLoS ONE [ 1932-6203 ] ; 2016.
Abstract
The aim of this study is to confirm the function of tumor-infiltrating lymphocytes (TILs) in sentinel lymph node (SLN) metastasis.
This retrospective study included 633 patients with invasive melanoma who underwent sentinel lymph node biopsy in 7 referral centers certified by the Brazilian Melanoma Group. Independent risk factors of sentinel node metastasis (SNL) were identified by multiple logistic regression.
SLN metastasis was detected in 101 of 633 cases (16.1%) and in 93 of 428 patients (21.7%) when melanomas ≤ 1mm were excluded. By multiple logistic regression, the absence of TILs was as an independent risk factor of SLN metastasis (OR = 1.8; 95%CI: 1.1–3.0), in addition to Breslow index (greater than 2.00 mm), lymph vascular invasion, and presence of mitosis.
SLNB can identify patients who might benefit from immunotherapy, and the determination of predictors of SLNB positivity can help select the proper population for this type of therapy. The absence of TILs is a reproducible parameter that can predict SLNB positivity in melanoma patients, since this study was made with several centers with different dermatopathologists.
Url:
DOI: 10.1371/journal.pone.0148160
PubMed: 26859408
PubMed Central: 4747578
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Moredo</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>AC Camargo Cancer Center, São Paulo, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>AC Camargo Cancer Center, São Paulo</wicri:regionArea></affiliation></author><author><name sortKey="Steck, Higino" sort="Steck, Higino" uniqKey="Steck H" first="Higino" last="Steck">Higino Steck</name><affiliation wicri:level="1"><nlm:aff id="aff008"><addr-line>Mario Gatti Hospital, Campinas, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Mario Gatti Hospital, Campinas</wicri:regionArea></affiliation></author><author><name sortKey="Brandao, Miguel" sort="Brandao, Miguel" uniqKey="Brandao M" first="Miguel" last="Brandão">Miguel Brandão</name><affiliation wicri:level="1"><nlm:aff id="aff009"><addr-line>AMO Clinic, Salvador, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>AMO Clinic, 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Ivan Dunshee De Oliveira" uniqKey="Santos I" first="Ivan Dunshee De Oliveira" last="Santos">Ivan Dunshee De Oliveira Santos</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Medical School, São Paulo Federal University, São Paulo, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Medical School, São Paulo Federal University, São Paulo</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26859408</idno><idno type="pmc">4747578</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4747578</idno><idno type="RBID">PMC:4747578</idno><idno type="doi">10.1371/journal.pone.0148160</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000832</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000832</idno><idno type="wicri:Area/Pmc/Curation">000832</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000832</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Absence of Tumor-Infiltrating Lymphocyte Is a Reproducible Predictive Factor for Sentinel Lymph Node Metastasis: A Multicenter Database Study by the Brazilian Melanoma Group</title><author><name sortKey="Duprat, Joao Pedreira" sort="Duprat, Joao Pedreira" uniqKey="Duprat J" first="João Pedreira" last="Duprat">João Pedreira Duprat</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>AC Camargo Cancer Center, São Paulo, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>AC Camargo Cancer Center, São Paulo</wicri:regionArea></affiliation></author><author><name sortKey="Brechtbulh, Eduard Rene" sort="Brechtbulh, Eduard Rene" uniqKey="Brechtbulh E" first="Eduard René" last="Brechtbülh">Eduard René Brechtbülh</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>AC Camargo Cancer Center, São Paulo, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>AC Camargo Cancer Center, São Paulo</wicri:regionArea></affiliation></author><author><name sortKey="Costa De Sa, Bianca" sort="Costa De Sa, Bianca" uniqKey="Costa De Sa B" first="Bianca" last="Costa De Sá">Bianca Costa De Sá</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>AC Camargo Cancer Center, São Paulo, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>AC Camargo Cancer Center, São Paulo</wicri:regionArea></affiliation></author><author><name sortKey="Enokihara, Mauro" sort="Enokihara, Mauro" uniqKey="Enokihara M" first="Mauro" last="Enokihara">Mauro Enokihara</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Medical School, São Paulo Federal University, São Paulo, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Medical School, São Paulo Federal University, São Paulo</wicri:regionArea></affiliation></author><author><name sortKey="Fregnani, Jose Humberto" sort="Fregnani, Jose Humberto" uniqKey="Fregnani J" first="Jose Humberto" last="Fregnani">Jose Humberto Fregnani</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Barretos Cancer Hospital, Barretos, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Barretos Cancer Hospital, Barretos</wicri:regionArea></affiliation></author><author><name sortKey="Landman, Gilles" sort="Landman, Gilles" uniqKey="Landman G" first="Gilles" last="Landman">Gilles Landman</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Medical School, São Paulo Federal University, São Paulo, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Medical School, São Paulo Federal University, São Paulo</wicri:regionArea></affiliation></author><author><name sortKey="Maia, Marcus" sort="Maia, Marcus" uniqKey="Maia M" first="Marcus" last="Maia">Marcus Maia</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Santa Casa de Misericórdia, São Paulo, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Santa Casa de Misericórdia, São Paulo</wicri:regionArea></affiliation></author><author><name sortKey="Riccardi, Felice" sort="Riccardi, Felice" uniqKey="Riccardi F" first="Felice" last="Riccardi">Felice Riccardi</name><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Santa Rita Hospital, Porto Alegre, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Santa Rita Hospital, Porto Alegre</wicri:regionArea></affiliation></author><author><name sortKey="Belfort, Francisco Alberto" sort="Belfort, Francisco Alberto" uniqKey="Belfort F" first="Francisco Alberto" last="Belfort">Francisco Alberto Belfort</name><affiliation wicri:level="1"><nlm:aff id="aff006"><addr-line>Sirio Libanês Hospital, Oswaldo Cruz Hospital, São José Hospital, São Paulo, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Sirio Libanês Hospital, Oswaldo Cruz Hospital, São José Hospital, São Paulo</wicri:regionArea></affiliation></author><author><name sortKey="Wainstein, Alberto" sort="Wainstein, Alberto" uniqKey="Wainstein A" first="Alberto" last="Wainstein">Alberto Wainstein</name><affiliation wicri:level="1"><nlm:aff id="aff007"><addr-line>Minas Gerais School of Medicine, Belo Horizonte, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Minas Gerais School of Medicine, Belo Horizonte</wicri:regionArea></affiliation></author><author><name sortKey="Moredo, Luciana F" sort="Moredo, Luciana F" uniqKey="Moredo L" first="Luciana F." last="Moredo">Luciana F. Moredo</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>AC Camargo Cancer Center, São Paulo, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>AC Camargo Cancer Center, São Paulo</wicri:regionArea></affiliation></author><author><name sortKey="Steck, Higino" sort="Steck, Higino" uniqKey="Steck H" first="Higino" last="Steck">Higino Steck</name><affiliation wicri:level="1"><nlm:aff id="aff008"><addr-line>Mario Gatti Hospital, Campinas, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Mario Gatti Hospital, Campinas</wicri:regionArea></affiliation></author><author><name sortKey="Brandao, Miguel" sort="Brandao, Miguel" uniqKey="Brandao M" first="Miguel" last="Brandão">Miguel Brandão</name><affiliation wicri:level="1"><nlm:aff id="aff009"><addr-line>AMO Clinic, Salvador, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>AMO Clinic, Salvador</wicri:regionArea></affiliation></author><author><name sortKey="Moreno, Marcelo" sort="Moreno, Marcelo" uniqKey="Moreno M" first="Marcelo" last="Moreno">Marcelo Moreno</name><affiliation wicri:level="1"><nlm:aff id="aff010"><addr-line>Medical School, Community University of Chapecó Region, Chapecó, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Medical School, Community University of Chapecó Region, Chapecó</wicri:regionArea></affiliation></author><author><name sortKey="Miranda, Eduardo" sort="Miranda, Eduardo" uniqKey="Miranda E" first="Eduardo" last="Miranda">Eduardo Miranda</name><affiliation wicri:level="1"><nlm:aff id="aff011"><addr-line>Oncology Department, Pernambuco University, Recife, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Oncology Department, Pernambuco University, Recife</wicri:regionArea></affiliation></author><author><name sortKey="Santos, Ivan Dunshee De Oliveira" sort="Santos, Ivan Dunshee De Oliveira" uniqKey="Santos I" first="Ivan Dunshee De Oliveira" last="Santos">Ivan Dunshee De Oliveira Santos</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Medical School, São Paulo Federal University, São Paulo, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Medical School, São Paulo Federal University, São Paulo</wicri:regionArea></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Aims</title><p>The aim of this study is to confirm the function of tumor-infiltrating lymphocytes (TILs) in sentinel lymph node (SLN) metastasis.</p></sec><sec id="sec002"><title>Materials and Methods</title><p>This retrospective study included 633 patients with invasive melanoma who underwent sentinel lymph node biopsy in 7 referral centers certified by the Brazilian Melanoma Group. Independent risk factors of sentinel node metastasis (SNL) were identified by multiple logistic regression.</p></sec><sec id="sec003"><title>Results</title><p>SLN metastasis was detected in 101 of 633 cases (16.1%) and in 93 of 428 patients (21.7%) when melanomas ≤ 1mm were excluded. By multiple logistic regression, the absence of TILs was as an independent risk factor of SLN metastasis (OR = 1.8; 95%CI: 1.1–3.0), in addition to Breslow index (greater than 2.00 mm), lymph vascular invasion, and presence of mitosis.</p></sec><sec id="sec004"><title>Conclusion</title><p>SLNB can identify patients who might benefit from immunotherapy, and the determination of predictors of SLNB positivity can help select the proper population for this type of therapy. The absence of TILs is a reproducible parameter that can predict SLNB positivity in melanoma patients, since this study was made with several centers with different dermatopathologists.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Wong, Sl" uniqKey="Wong S">SL Wong</name></author><author><name sortKey="Balch, Cm" uniqKey="Balch C">CM Balch</name></author><author><name sortKey="Hurley, P" uniqKey="Hurley P">P Hurley</name></author><author><name sortKey="Agarwala, Ss" uniqKey="Agarwala S">SS Agarwala</name></author><author><name sortKey="Akhurst, Tj" uniqKey="Akhurst T">TJ Akhurst</name></author><author><name sortKey="Cochran, A" uniqKey="Cochran A">A Cochran</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Garbe, C" uniqKey="Garbe C">C Garbe</name></author><author><name sortKey="Schadendorf, D" uniqKey="Schadendorf D">D Schadendorf</name></author><author><name sortKey="Stolz, W" 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, CA USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26859408</article-id><article-id pub-id-type="pmc">4747578</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0148160</article-id><article-id pub-id-type="publisher-id">PONE-D-15-28051</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Oncology</subject><subj-group><subject>Cancers and Neoplasms</subject><subj-group><subject>Melanomas</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Oncology</subject><subj-group><subject>Basic Cancer Research</subject><subj-group><subject>Metastasis</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Oncology</subject><subj-group><subject>Cancer Detection and Diagnosis</subject><subj-group><subject>Lymphatic Mapping</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Anatomy</subject><subj-group><subject>Lymphatic System</subject><subj-group><subject>Lymph Nodes</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Anatomy</subject><subj-group><subject>Lymphatic System</subject><subj-group><subject>Lymph Nodes</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Cell Biology</subject><subj-group><subject>Cell Processes</subject><subj-group><subject>Cell Cycle and Cell Division</subject><subj-group><subject>Mitosis</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Cell Biology</subject><subj-group><subject>Chromosome Biology</subject><subj-group><subject>Mitosis</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Anatomy</subject><subj-group><subject>Body Fluids</subject><subj-group><subject>Lymph</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Anatomy</subject><subj-group><subject>Body Fluids</subject><subj-group><subject>Lymph</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Physiology</subject><subj-group><subject>Body Fluids</subject><subj-group><subject>Lymph</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Physiology</subject><subj-group><subject>Body Fluids</subject><subj-group><subject>Lymph</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Cell Biology</subject><subj-group><subject>Cellular Types</subject><subj-group><subject>Animal Cells</subject><subj-group><subject>Blood Cells</subject><subj-group><subject>White Blood Cells</subject><subj-group><subject>Tumor-Infiltrating Lymphocytes</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Cell Biology</subject><subj-group><subject>Cellular Types</subject><subj-group><subject>Animal Cells</subject><subj-group><subject>Immune Cells</subject><subj-group><subject>White Blood Cells</subject><subj-group><subject>Tumor-Infiltrating Lymphocytes</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Immunology</subject><subj-group><subject>Immune Cells</subject><subj-group><subject>White Blood Cells</subject><subj-group><subject>Tumor-Infiltrating Lymphocytes</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Immunology</subject><subj-group><subject>Immune Cells</subject><subj-group><subject>White Blood Cells</subject><subj-group><subject>Tumor-Infiltrating Lymphocytes</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Surgical and Invasive Medical Procedures</subject><subj-group><subject>Biopsy</subject></subj-group></subj-group></subj-group></article-categories><title-group><article-title>Absence of Tumor-Infiltrating Lymphocyte Is a Reproducible Predictive Factor for Sentinel Lymph Node Metastasis: A Multicenter Database Study by the Brazilian Melanoma Group</article-title><alt-title alt-title-type="running-head">Reproducibility of TIL in Melanoma for Sentinel Lymph Node Status</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Duprat</surname><given-names>João Pedreira</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref><xref ref-type="corresp" rid="cor001">*</xref></contrib><contrib contrib-type="author"><name><surname>Brechtbülh</surname><given-names>Eduard René</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Costa de Sá</surname><given-names>Bianca</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Enokihara</surname><given-names>Mauro</given-names></name><xref ref-type="aff" rid="aff002"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Fregnani</surname><given-names>Jose Humberto</given-names></name><xref ref-type="aff" rid="aff003"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Landman</surname><given-names>Gilles</given-names></name><xref ref-type="aff" rid="aff002"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Maia</surname><given-names>Marcus</given-names></name><xref ref-type="aff" rid="aff004"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Riccardi</surname><given-names>Felice</given-names></name><xref ref-type="aff" rid="aff005"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Belfort</surname><given-names>Francisco Alberto</given-names></name><xref ref-type="aff" rid="aff006"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Wainstein</surname><given-names>Alberto</given-names></name><xref ref-type="aff" rid="aff007"><sup>7</sup></xref></contrib><contrib contrib-type="author"><name><surname>Moredo</surname><given-names>Luciana F.</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Steck</surname><given-names>Higino</given-names></name><xref ref-type="aff" rid="aff008"><sup>8</sup></xref></contrib><contrib contrib-type="author"><name><surname>Brandão</surname><given-names>Miguel</given-names></name><xref ref-type="aff" rid="aff009"><sup>9</sup></xref></contrib><contrib contrib-type="author"><name><surname>Moreno</surname><given-names>Marcelo</given-names></name><xref ref-type="aff" rid="aff010"><sup>10</sup></xref></contrib><contrib contrib-type="author"><name><surname>Miranda</surname><given-names>Eduardo</given-names></name><xref ref-type="aff" rid="aff011"><sup>11</sup></xref></contrib><contrib contrib-type="author"><name><surname>Santos</surname><given-names>Ivan Dunshee de Oliveira</given-names></name><xref ref-type="aff" rid="aff002"><sup>2</sup></xref></contrib></contrib-group><aff id="aff001"><label>1</label><addr-line>AC Camargo Cancer Center, São Paulo, Brazil</addr-line></aff><aff id="aff002"><label>2</label><addr-line>Medical School, São Paulo Federal University, São Paulo, Brazil</addr-line></aff><aff id="aff003"><label>3</label><addr-line>Barretos Cancer Hospital, Barretos, Brazil</addr-line></aff><aff id="aff004"><label>4</label><addr-line>Santa Casa de Misericórdia, São Paulo, Brazil</addr-line></aff><aff id="aff005"><label>5</label><addr-line>Santa Rita Hospital, Porto Alegre, Brazil</addr-line></aff><aff id="aff006"><label>6</label><addr-line>Sirio Libanês Hospital, Oswaldo Cruz Hospital, São José Hospital, São Paulo, Brazil</addr-line></aff><aff id="aff007"><label>7</label><addr-line>Minas Gerais School of Medicine, Belo Horizonte, Brazil</addr-line></aff><aff id="aff008"><label>8</label><addr-line>Mario Gatti Hospital, Campinas, Brazil</addr-line></aff><aff id="aff009"><label>9</label><addr-line>AMO Clinic, Salvador, Brazil</addr-line></aff><aff id="aff010"><label>10</label><addr-line>Medical School, Community University of Chapecó Region, Chapecó, Brazil</addr-line></aff><aff id="aff011"><label>11</label><addr-line>Oncology Department, Pernambuco University, Recife, Brazil</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Slominski</surname><given-names>Andrzej T</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>University of Alabama at Birmingham, UNITED STATES</addr-line></aff><author-notes><fn fn-type="conflict" id="coi001"><p><bold>Competing Interests: </bold>The authors have declared that no competing interests exist.</p></fn><fn fn-type="con" id="contrib001"><p>Conceived and designed the experiments: JPD IDOS M. Maia ME FAB ERB. Analyzed the data: JHF. Wrote the paper: JPD ERB BCS ME JHF GL M. Maia FR FAB HS MB M. Moreno EM IDOS. Collecting data: JPD ERB BCS ME JHF GL M. Maia FR FAB AW LFM HS MB M. Moreno EM IDOS. Organizing the database: ERB LFM.</p></fn><corresp id="cor001">* E-mail: <email>joao.duprat@accarmargo.org.br</email></corresp></author-notes><pub-date pub-type="epub"><day>9</day><month>2</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>11</volume><issue>2</issue><elocation-id>e0148160</elocation-id><history><date date-type="received"><day>30</day><month>6</month><year>2015</year></date><date date-type="accepted"><day>13</day><month>1</month><year>2016</year></date></history><permissions><copyright-statement>© 2016 Duprat et al</copyright-statement><copyright-year>2016</copyright-year><copyright-holder>Duprat et al</copyright-holder><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><self-uri content-type="pdf" xlink:type="simple" xlink:href="pone.0148160.pdf"></self-uri><abstract><sec id="sec001"><title>Aims</title><p>The aim of this study is to confirm the function of tumor-infiltrating lymphocytes (TILs) in sentinel lymph node (SLN) metastasis.</p></sec><sec id="sec002"><title>Materials and Methods</title><p>This retrospective study included 633 patients with invasive melanoma who underwent sentinel lymph node biopsy in 7 referral centers certified by the Brazilian Melanoma Group. Independent risk factors of sentinel node metastasis (SNL) were identified by multiple logistic regression.</p></sec><sec id="sec003"><title>Results</title><p>SLN metastasis was detected in 101 of 633 cases (16.1%) and in 93 of 428 patients (21.7%) when melanomas ≤ 1mm were excluded. By multiple logistic regression, the absence of TILs was as an independent risk factor of SLN metastasis (OR = 1.8; 95%CI: 1.1–3.0), in addition to Breslow index (greater than 2.00 mm), lymph vascular invasion, and presence of mitosis.</p></sec><sec id="sec004"><title>Conclusion</title><p>SLNB can identify patients who might benefit from immunotherapy, and the determination of predictors of SLNB positivity can help select the proper population for this type of therapy. The absence of TILs is a reproducible parameter that can predict SLNB positivity in melanoma patients, since this study was made with several centers with different dermatopathologists.</p></sec></abstract><funding-group><funding-statement>The authors have no support or funding to report.</funding-statement></funding-group><counts><fig-count count="0"></fig-count><table-count count="3"></table-count><page-count count="9"></page-count></counts><custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name><meta-value>Data contain potentially identifying information and are unsuitable for public deposition. Data requests may be sent to the corresponding author.</meta-value></custom-meta></custom-meta-group></article-meta><notes><title>Data Availability</title><p>Data contain potentially identifying information and are unsuitable for public deposition. Data requests may be sent to the corresponding author.</p></notes></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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