SLN melanoma micrometastasis predictivity of nodal status: a long term retrospective study
Identifieur interne : 002B05 ( Pmc/Curation ); précédent : 002B04; suivant : 002B06SLN melanoma micrometastasis predictivity of nodal status: a long term retrospective study
Auteurs : Emilia Migliano [Italie] ; Barbara Bellei [Italie] ; Flavio Andrea Govoni [Italie] ; Giovanni Paolino [Italie] ; Caterina Catricalà [Italie] ; Stefania Bucher [Italie] ; Pietro Donati [Italie]Source :
- Journal of Experimental & Clinical Cancer Research : CR [ 0392-9078 ] ; 2013.
Abstract
Completion lymph node dissection (CLND) is the gold standard treatment for patients with a positive sentinel lymph node (SLN) biopsy. Considering the morbidity associated with CLND it is important to identify histological features of the primary tumor and/or of SLN metastasis that could help to spare from CLND a subset of patients who have a very low risk of non-SLN metastasis. The objective of this study is to identify patients with a very low risk to develop non-SLNs recurrences and to limit unnecessary CLND.
A retrospective long-term study of 80 melanoma patients with positive SLN, undergone CLND, was assessed to define the risk of additional metastasis in the regional nodal basin, on the basis of intranodal distribution of metastatic cells, using the micro-morphometric analysis (Starz classification).
This study demonstrates that among the demographic and pathologic features of primary melanoma and of SLN only the Starz classification shows prognostic significance for non-SLN status (p<0.0001). This parameter was also significantly associated with disease-free survival rate (p<0.0013).
The Starz classification can help to identify, among SLN positive patients, those who can have a real benefit from CLND. From the clinical point of view this easy and reliable method could lead to a significant reduction of unnecessary CLND in association with a substantial decrease in morbidity. The study results indicate that most of S1 subgroup patients might be safely spared from completion lymphatic node dissection. Furthermore, our experience demonstrated that Starz classification of SLN is a safe predictive index for patient stratification and treatment planning.
Url:
DOI: 10.1186/1756-9966-32-47
PubMed: 23902987
PubMed Central: 3737095
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<author><name sortKey="Bellei, Barbara" sort="Bellei, Barbara" uniqKey="Bellei B" first="Barbara" last="Bellei">Barbara Bellei</name>
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<author><name sortKey="Govoni, Flavio Andrea" sort="Govoni, Flavio Andrea" uniqKey="Govoni F" first="Flavio Andrea" last="Govoni">Flavio Andrea Govoni</name>
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<series><title level="j">Journal of Experimental & Clinical Cancer Research : CR</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Completion lymph node dissection (CLND) is the gold standard treatment for patients with a positive sentinel lymph node (SLN) biopsy. Considering the morbidity associated with CLND it is important to identify histological features of the primary tumor and/or of SLN metastasis that could help to spare from CLND a subset of patients who have a very low risk of non-SLN metastasis. The objective of this study is to identify patients with a very low risk to develop non-SLNs recurrences and to limit unnecessary CLND.</p>
</sec>
<sec><title>Methods</title>
<p>A retrospective long-term study of 80 melanoma patients with positive SLN, undergone CLND, was assessed to define the risk of additional metastasis in the regional nodal basin, on the basis of intranodal distribution of metastatic cells, using the micro-morphometric analysis (Starz classification).</p>
</sec>
<sec><title>Results</title>
<p>This study demonstrates that among the demographic and pathologic features of primary melanoma and of SLN only the Starz classification shows prognostic significance for non-SLN status (p<0.0001). This parameter was also significantly associated with disease-free survival rate (p<0.0013).</p>
</sec>
<sec><title>Conclusion</title>
<p>The Starz classification can help to identify, among SLN positive patients, those who can have a real benefit from CLND. From the clinical point of view this easy and reliable method could lead to a significant reduction of unnecessary CLND in association with a substantial decrease in morbidity. The study results indicate that most of S1 subgroup patients might be safely spared from completion lymphatic node dissection. Furthermore, our experience demonstrated that Starz classification of SLN is a safe predictive index for patient stratification and treatment planning.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article" xml:lang="en"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Exp Clin Cancer Res</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Exp. Clin. Cancer Res</journal-id>
<journal-title-group><journal-title>Journal of Experimental & Clinical Cancer Research : CR</journal-title>
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<issn pub-type="ppub">0392-9078</issn>
<issn pub-type="epub">1756-9966</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
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</journal-meta>
<article-meta><article-id pub-id-type="pmid">23902987</article-id>
<article-id pub-id-type="pmc">3737095</article-id>
<article-id pub-id-type="publisher-id">1756-9966-32-47</article-id>
<article-id pub-id-type="doi">10.1186/1756-9966-32-47</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research</subject>
</subj-group>
</article-categories>
<title-group><article-title>SLN melanoma micrometastasis predictivity of nodal status: a long term retrospective study</article-title>
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<email>migliano@ifo.it</email>
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<contrib contrib-type="author" id="A4"><name><surname>Paolino</surname>
<given-names>Giovanni</given-names>
</name>
<xref ref-type="aff" rid="I4">4</xref>
<email>paolgio@libero.it</email>
</contrib>
<contrib contrib-type="author" id="A5"><name><surname>Catricalà</surname>
<given-names>Caterina</given-names>
</name>
<xref ref-type="aff" rid="I5">5</xref>
<email>catricala@ifo.it</email>
</contrib>
<contrib contrib-type="author" id="A6"><name><surname>Bucher</surname>
<given-names>Stefania</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>bucher@ifo.it</email>
</contrib>
<contrib contrib-type="author" id="A7"><name><surname>Donati</surname>
<given-names>Pietro</given-names>
</name>
<xref ref-type="aff" rid="I4">4</xref>
<email>donati@ifo.it</email>
</contrib>
</contrib-group>
<aff id="I1"><label>1</label>
Department of Plastic and Reconstructive Surgery, San Gallicano Dermatologic Institute, Rome, Italy</aff>
<aff id="I2"><label>2</label>
Laboratory of Cutaneous Physiopathology, San Gallicano Dermatologic Institute, Rome, Italy</aff>
<aff id="I3"><label>3</label>
Department of Maxillofacial Surgery, San Filippo Neri Hospital, Rome, Italy</aff>
<aff id="I4"><label>4</label>
Dermatopathology Unit, San Gallicano Dermatologic Institute, Rome, Italy</aff>
<aff id="I5"><label>5</label>
Department of Dermatology-Oncology, San Gallicano Dermatologic Institute, Rome, Italy</aff>
<pub-date pub-type="collection"><year>2013</year>
</pub-date>
<pub-date pub-type="epub"><day>1</day>
<month>8</month>
<year>2013</year>
</pub-date>
<volume>32</volume>
<issue>1</issue>
<fpage>47</fpage>
<lpage>47</lpage>
<history><date date-type="received"><day>4</day>
<month>6</month>
<year>2013</year>
</date>
<date date-type="accepted"><day>26</day>
<month>7</month>
<year>2013</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2013 Migliano et al.; licensee BioMed Central Ltd.</copyright-statement>
<copyright-year>2013</copyright-year>
<copyright-holder>Migliano et al.; licensee BioMed Central Ltd.</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<self-uri xlink:href="http://www.jeccr.com/content/32/1/47"></self-uri>
<abstract><sec><title>Background</title>
<p>Completion lymph node dissection (CLND) is the gold standard treatment for patients with a positive sentinel lymph node (SLN) biopsy. Considering the morbidity associated with CLND it is important to identify histological features of the primary tumor and/or of SLN metastasis that could help to spare from CLND a subset of patients who have a very low risk of non-SLN metastasis. The objective of this study is to identify patients with a very low risk to develop non-SLNs recurrences and to limit unnecessary CLND.</p>
</sec>
<sec><title>Methods</title>
<p>A retrospective long-term study of 80 melanoma patients with positive SLN, undergone CLND, was assessed to define the risk of additional metastasis in the regional nodal basin, on the basis of intranodal distribution of metastatic cells, using the micro-morphometric analysis (Starz classification).</p>
</sec>
<sec><title>Results</title>
<p>This study demonstrates that among the demographic and pathologic features of primary melanoma and of SLN only the Starz classification shows prognostic significance for non-SLN status (p<0.0001). This parameter was also significantly associated with disease-free survival rate (p<0.0013).</p>
</sec>
<sec><title>Conclusion</title>
<p>The Starz classification can help to identify, among SLN positive patients, those who can have a real benefit from CLND. From the clinical point of view this easy and reliable method could lead to a significant reduction of unnecessary CLND in association with a substantial decrease in morbidity. The study results indicate that most of S1 subgroup patients might be safely spared from completion lymphatic node dissection. Furthermore, our experience demonstrated that Starz classification of SLN is a safe predictive index for patient stratification and treatment planning.</p>
</sec>
</abstract>
<kwd-group><kwd>Sentinel lymph node</kwd>
<kwd>SLN</kwd>
<kwd>CLND</kwd>
<kwd>Starz classification</kwd>
<kwd>Melanoma micrometastasis</kwd>
<kwd>Nodal status</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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