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Randerson-Moor J, Davies J, Harland M, Nsengimana J, Bigirumurame T, Walker C, Laye J, Appleton ES, Ball G, Cook GP, Bishop DT, Salmond RJ, Newton-Bishop J. Systemic inflammation, the peripheral blood transcriptome and primary melanoma. J Invest Dermatol 2024:S0022-202X(24)00275-6. [PMID: 38583742 DOI: 10.1016/j.jid.2024.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 04/09/2024]
Abstract
Peripheral blood transcriptomes from 383 newly-diagnosed melanoma patients were subjected to differential gene expression analysis. The hypotheses were that impaired systemic immunity is associated with poorer prognosis (thicker tumors and fewer tumor infiltrating lymphocytes (TILs)) and evidence of systemic inflammation (high-sensitivity C-reactive protein (hsCRP) and fibrinogen levels). Higher fibrinogen levels were associated with thicker primaries. In single gene analysis hsCRP levels were significantly associated with higher blood CD274 expression, (coding for PD-L1), but each was independently prognostic, with hsCRP associated with increased mortality, and higher CD274 protective, independent of age. Pathway analysis identified downregulation of immune cell signalling pathways in the blood of people with thicker tumors and notable upregulation of STAT1 in people with brisk TILs. Transcriptomic data provided evidence for increased NFB signalling with higher inflammatory markers but with reduction in expression of HLA class II molecules and higher CD274 suggesting that aberrant systemic inflammation is a significant mediator of reduced immune function in melanoma. In summary, transcriptomic data revealed evidence of reduced immune function in patients with thicker tumors and fewer TILs, at diagnosis. Inflammatory markers were associated with thicker primaries and independently with death from melanoma suggesting that systemic inflammation contributes to that reduced immune function.
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Silva García GA, Sánchez Cárdenas CD, Mendoza Ibarra T, Pérez Martínez CA, Guevara Castillo RM, Pulido Díaz N. Clinical and Histopathologic Features of Subungual Melanoma in 57 Mexican Patients: A 5-Year Cohort Study. Actas Dermosifiliogr 2024; 115:293-297. [PMID: 37871891 DOI: 10.1016/j.ad.2023.05.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/04/2023] [Accepted: 05/12/2023] [Indexed: 10/25/2023] Open
Abstract
Although subungual melanoma is uncommon, it is associated with worse outcomes than melanomas in other locations and accounts for 1% to 23% of all melanomas, depending on the population. The aim of this study was to describe the clinical and histopathologic features of subungual melanoma in a Mexican population. We identified 303 patients with melanoma, and of these, 19% (57 patients with a median age of 71 years) had subungual melanoma. The main sites affected were the lower limbs (52.6%) and the toe (75.4%). The most common histologic subtype was acral lentiginous melanoma (50.9%). Median Breslow thickness was 3 mm, and stage IA tumors were the most common (in 28.1% of patients). Recurrence and metastasis occurred in 19.3% and 8.8% of patients, respectively. The clinical and histopathologic features identified are similar to those described in the literature. Early diagnosis and treatment are crucial for improving prognosis.
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Affiliation(s)
- G A Silva García
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, México
| | - C D Sánchez Cárdenas
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, México.
| | - T Mendoza Ibarra
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, México
| | - C A Pérez Martínez
- Departamento de Medicina Interna, Hospital General «Ajusco Medio», Secretaría de Salud de México, Estado de México, México
| | - R M Guevara Castillo
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, México
| | - N Pulido Díaz
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, México
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3
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Silva García GA, Sánchez Cárdenas CD, Mendoza Ibarra T, Pérez Martínez CA, Guevara Castillo RM, Pulido Díaz N. [Translated article] Clinical and Histopathologic Features of Subungual Melanoma in 57 Mexican Patients: A 5-Year Cohort Study. Actas Dermosifiliogr 2024; 115:T293-T297. [PMID: 38242433 DOI: 10.1016/j.ad.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/12/2023] [Indexed: 01/21/2024] Open
Abstract
Although subungual melanoma is uncommon, it is associated with worse outcomes than melanomas in other locations and accounts for 1% to 23% of all melanomas, depending on the population. The aim of this study was to describe the clinical and histopathologic features of subungual melanoma in a Mexican population. We identified 303 patients with melanoma, and of these, 19% (57 patients with a median age of 71 years) had subungual melanoma. The main sites affected were the lower limbs (52.6%) and the toe (75.4%). The most common histologic subtype was acral lentiginous melanoma (50.9%). Median Breslow thickness was 3 mm, and stage IA tumors were the most common (in 28.1% of patients). Recurrence and metastasis occurred in 19.3% and 8.8% of patients, respectively. The clinical and histopathologic features identified are similar to those described in the literature. Early diagnosis and treatment are crucial for improving prognosis.
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Affiliation(s)
- G A Silva García
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, Mexico
| | - C D Sánchez Cárdenas
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, Mexico.
| | - T Mendoza Ibarra
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, Mexico
| | - C A Pérez Martínez
- Departamento de Medicina Interna, Hospital General «Ajusco Medio», Secretaría de Salud de México, Estado de México, Mexico
| | - R M Guevara Castillo
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, Mexico
| | - N Pulido Díaz
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, Mexico
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Jeremić J, Radenović K, Jurišić M, Suđecki B, Marinković M, Mihaljević J, Radosavljević I, Jovanović M, Stojanović M, Milić N, Pavlović V, Stojičić M, Inić Z, Jović M. Primary Melanoma Histopathologic Predictors of Sentinel Lymph Node Positivity: A Proposed Scoring System for Risk Assessment and Patient Selection in a Clinical Setting. Medicina (Kaunas) 2023; 59:1921. [PMID: 38003969 PMCID: PMC10673032 DOI: 10.3390/medicina59111921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/23/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: The careful selection of adequate SLNB candidates not only aims at reducing the surgical risk while identifying SLN metastasis, but also plays a crucial role in identifying the patients eligible for adjuvant therapy. Objectives: The purpose of our study was to investigate the clinical and histologic aspects of primary melanomas that correlate with the likelihood of a positive SLNB result. Materials and Methods: A total of 101 primary melanoma patients who underwent sentinel lymph node biopsies were included in the study. General patient demographics were obtained as well as localization and melanoma-specific characteristics of primary melanoma from histologic reports in addition to data derived from SLNB melanoma histopathology reports. Results: The patients with positive SLN results had a statistically significant increased Breslow thickness (3.8 mm vs. 1.97 mm, p = 0.002), higher mitotic index rate (5/mm2 vs. 2/mm2, p = 0.009), as well as the presence of ulceration (68.4% vs. 31.6%, p = 0.007). Univariate regression analysis showed the Breslow thickness (p = 0.008), the mitotic index rate (p = 0.054), the presence of ulceration (p = 0.009), as well as the pT3-4 stage (p = 0.009) to be significant predictors of SLN positivity. The optimal cut-off values for Breslow thickness and the number of mitoses scores were determined based on ROC curve analysis. Using the Breslow thickness, mitotic index rate, presence of ulceration, and pT3-4 stage significant coefficients from the univariate regression model, a chance prediction score was developed. Conclusions: The newly developed and proposed scoring system can aid in patient selection for SLN biopsy by facilitating a more efficient risk assessment in the detection of lymph node metastases in melanoma patients.
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Affiliation(s)
- Jelena Jeremić
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia (I.R.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia (Z.I.)
| | - Kristina Radenović
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia (I.R.)
| | - Milana Jurišić
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia (I.R.)
| | - Branko Suđecki
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia (I.R.)
| | - Milana Marinković
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia (I.R.)
| | - Jovan Mihaljević
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia (I.R.)
| | - Ivan Radosavljević
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia (I.R.)
| | - Milan Jovanović
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia (I.R.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia (Z.I.)
| | - Marina Stojanović
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia (Z.I.)
- Center for Anesthesia, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Nataša Milić
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia (Z.I.)
- Institute for Medical Statistics and Informatics, 11000 Belgrade, Serbia
| | - Vedrana Pavlović
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia (Z.I.)
- Institute for Medical Statistics and Informatics, 11000 Belgrade, Serbia
| | - Milan Stojičić
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia (I.R.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia (Z.I.)
| | - Zorka Inić
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia (Z.I.)
- Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, 11000 Belgrade, Serbia
| | - Marko Jović
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia (I.R.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia (Z.I.)
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Țăpoi DA, Derewicz D, Gheorghișan-Gălățeanu AA, Dumitru AV, Ciongariu AM, Costache M. The Impact of Clinical and Histopathological Factors on Disease Progression and Survival in Thick Cutaneous Melanomas. Biomedicines 2023; 11:2616. [PMID: 37892990 PMCID: PMC10604442 DOI: 10.3390/biomedicines11102616] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
Thick cutaneous melanomas (Breslow depth > 4 mm) are locally advanced tumors, generally associated with poor prognosis. Nevertheless, these tumors sometimes display unpredictable behavior. This study aims to analyze clinical and histopathological features that can influence the prognosis of thick melanomas. This is a retrospective study on 94 thick primary cutaneous melanomas diagnosed between 2012 and 2018 that were followed-up for at least five years to assess disease progression and survival. We evaluated the age, gender, tumor location, histological subtype, Breslow depth, Clark level, resection margins, mitotic index, the presence/absence of ulceration, necrosis, regression, microsatellites, neurotropism, lymphovascular invasion, and the pattern of tumor-infiltrating lymphocytes, and their association with disease progression and survival. By conducting univariate analysis, we found that progression-free survival (PFS) was significantly associated with female gender, the superficial spreading melanoma (SSM) subtype, mitotic index, necrosis, microsatellites, and perineural invasion. Overall survival (OS) was significantly associated with female gender, Breslow depth, SSM subtype, necrosis, microsatellites, and perineural invasion. Through multivariate Cox proportional hazards regression, we found that the only factors associated with PFS were Breslow depth, necrosis, microsatellites, and perineural invasion, while the factors associated with OS were Breslow depth, necrosis, microsatellites, and perineural invasion. Certain histopathological features such as Breslow depth, necrosis, microsatellites, and perineural invasion could explain differences in disease evolution. This is one of the first studies to demonstrate an association between necrosis and perineural invasion and outcomes in patients with thick melanomas. By identifying high-risk patients, personalized therapy can be provided for improved prognosis.
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Affiliation(s)
- Dana Antonia Țăpoi
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (D.A.Ț.); (A.M.C.); (M.C.)
- Department of Pathology, University Emergency Hospital, 050098 Bucharest, Romania
| | - Diana Derewicz
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Pediatric Hematology and Oncology, Marie Sklodowska Curie Clinical Emergency Hospital, 041447 Bucharest, Romania
| | - Ancuța-Augustina Gheorghișan-Gălățeanu
- Department of Cellular and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- C.I. Parhon National Institute of Endocrinology, 011863 Bucharest, Romania
| | - Adrian Vasile Dumitru
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (D.A.Ț.); (A.M.C.); (M.C.)
- Department of Pathology, University Emergency Hospital, 050098 Bucharest, Romania
| | - Ana Maria Ciongariu
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (D.A.Ț.); (A.M.C.); (M.C.)
- Department of Pathology, University Emergency Hospital, 050098 Bucharest, Romania
| | - Mariana Costache
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (D.A.Ț.); (A.M.C.); (M.C.)
- Department of Pathology, University Emergency Hospital, 050098 Bucharest, Romania
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6
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Demaerel PG, Leloup A, Brochez L, Van Eycken L, Garmyn M. Impact of the COVID-19 Pandemic on the Incidence and Thickness of Cutaneous Melanoma in Belgium. Biomedicines 2023; 11:1645. [PMID: 37371740 DOI: 10.3390/biomedicines11061645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: COVID-19 had a major impact on cancer diagnostics and treatment. Delays in diagnosis of cutaneous melanoma were particularly feared, given the impact on survival and morbidity that comes with advanced stages. Moreover, its incidence in Belgium has been rapidly increasing in recent decades. This Belgian population-level study quantifies the pandemic effect on the number of melanoma diagnoses and Breslow thickness in 2020 and 2021. (2) Methods: In using an automated algorithm, the number of cutaneous melanoma diagnoses and Breslow thickness were extracted from all pathology protocols from 2017-2021 by the Belgian Cancer Registry. Monthly variations, as well as year-to-year differences, were studied. (3) Results: Annual incidence of cutaneous melanoma fell by 1% in 2020, compared to 2019, mainly due to a diagnostic deficit in March, April, and May 2020. An 8% incidence increase occurred in 2021, primarily reflecting an increase in the number of the thinnest melanomas (≤1 mm). Both the mean and median Breslow thicknesses were higher in spring 2020, resulting from an underrepresentation of thinner tumors. However, no particulars stood out on a full-year basis in either 2020 or 2021. (4) Conclusions: Considering the expected incidence increase, we estimate almost 210 melanoma diagnoses were missed in Belgium in 2020, corresponding to 6% of the expected number. This deficit occurred mainly during the first COVID-19 wave. Despite some rebound, the 2021 total was still 3% short of the expected number, leaving around 325 diagnoses remaining pending in 2020 and 2021, corresponding to a two-year deficit of 4.35%. Fortunately, mainly thin melanomas were missed, without any detectable shift toward thicker tumors later in 2020 and or 2021.
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Affiliation(s)
| | | | - Lieve Brochez
- Department of Dermatology, Ghent University Hospital, 9000 Ghent, Belgium
| | | | - Marjan Garmyn
- Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium
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Johansson H, Spadola G, Tosti G, Mandalà M, Minisini AM, Queirolo P, Aristarco V, Baldini F, Cocorocchio E, Albertazzi E, Zichichi L, Cinieri S, Jemos C, Mazzarol G, Gnagnarella P, Macis D, Tedeschi I, Salè EO, Stucci LS, Bonanni B, Testori A, Pennacchioli E, Ferrucci PF, Gandini S. Vitamin D Supplementation and Disease-Free Survival in Stage II Melanoma: A Randomized Placebo Controlled Trial. Nutrients 2021; 13:nu13061931. [PMID: 34199802 PMCID: PMC8226808 DOI: 10.3390/nu13061931] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 12/29/2022] Open
Abstract
Patients with newly resected stage II melanoma (n = 104) were randomized to receive adjuvant vitamin D3 (100,000 IU every 50 days) or placebo for 3 years to investigate vitamin D3 protective effects on developing a recurrent disease. Median age at diagnosis was 50 years, and 43% of the patients were female. Median serum 25-hydroxy vitamin D (25OHD) level at baseline was 18 ng/mL, interquartile range (IQ) was 13–24 ng/mL, and 80% of the patients had insufficient vitamin D levels. We observed pronounced increases in 25OHD levels after 4 months in the active arm (median 32.9 ng/mL; IQ range 25.9–38.4) against placebo (median 19.05 ng/mL; IQ range 13.0–25.9), constantly rising during treatment. Remarkably, patients with low Breslow score (<3 mm) had a double increase in 25OHD levels from baseline, whereas patients with Breslow score ≥3 mm had a significantly lower increase over time. After 12 months, subjects with low 25OHD levels and Breslow score ≥3 mm had shorter disease-free survival (p = 0.02) compared to those with Breslow score <3 mm and/or high levels of 25OHD. Adjusting for age and treatment arm, the hazard ratio for relapse was 4.81 (95% CI: 1.44–16.09, p = 0.011). Despite the evidence of a role of 25OHD in melanoma prognosis, larger trials with vitamin D supplementation involving subjects with melanoma are needed.
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Affiliation(s)
- Harriet Johansson
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (V.A.); (D.M.); (B.B.)
- Correspondence: ; Tel.: +39-0294372654
| | - Giuseppe Spadola
- Divisione di Chirurgia del Melanoma, IRCCS Fondazione Istituto Nazionale per lo Studio e la Cura dei Tumori, 20133 Milan, Italy;
| | - Giulio Tosti
- Division of Surgery for Melanoma, Sarcoma, and Rare Tumors, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.T.); (F.B.); (I.T.); (E.P.)
| | - Mario Mandalà
- Unit of Medical Oncology, Department of Oncology and Haematology, Papa Giovanni XXIII Cancer Center Hospital, 24127 Bergamo, Italy;
| | - Alessandro M. Minisini
- Department of Oncology, Azienda Sanitaria Universitaria del Friuli Centrale, 33100 Udine, Italy;
| | - Paola Queirolo
- Department of Medical Oncology, IRCCS Ospedale Policlinico San Martino—IST-Istituto Nazionale per la Ricerca sul Cancro, 16132 Genoa, Italy;
| | - Valentina Aristarco
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (V.A.); (D.M.); (B.B.)
| | - Federica Baldini
- Division of Surgery for Melanoma, Sarcoma, and Rare Tumors, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.T.); (F.B.); (I.T.); (E.P.)
| | - Emilia Cocorocchio
- Division of Medical Oncology for Melanoma, Sarcoma and Rare Tumors, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy;
| | - Elena Albertazzi
- San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | | | - Saverio Cinieri
- Medical Oncology & Breast Unit, Department of Oncology, “Antonio Perrino” Hospital, 72100 Brindisi, Italy;
| | - Costantino Jemos
- Division of Pharmacy, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (C.J.); (E.O.S.)
| | - Giovanni Mazzarol
- Division of Pathology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy;
| | - Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy;
| | - Debora Macis
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (V.A.); (D.M.); (B.B.)
| | - Ines Tedeschi
- Division of Surgery for Melanoma, Sarcoma, and Rare Tumors, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.T.); (F.B.); (I.T.); (E.P.)
| | - Emanuela Omodeo Salè
- Division of Pharmacy, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (C.J.); (E.O.S.)
| | - Luigia Stefania Stucci
- Section of Medical Oncology, Department of Biomedical Sciences and Clinical Oncology (DIMO), University of Bari ‘Aldo Moro’, 70124 Bari, Italy;
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (V.A.); (D.M.); (B.B.)
| | - Alessandro Testori
- EORTC Melanoma Group, 1200 Brussel, Belgium;
- Skin Oncology Division, Image Rigenerative Clinic, 20121 Milan, Italy
| | - Elisabetta Pennacchioli
- Division of Surgery for Melanoma, Sarcoma, and Rare Tumors, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.T.); (F.B.); (I.T.); (E.P.)
| | - Pier Francesco Ferrucci
- Biotherapy of Tumors Unit, IEO, Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20141 Milan, Italy;
| | - Sara Gandini
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy;
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8
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Sanchez P, Adamo M(P, Lam CJ, Steven J, Brest A, Negoita S. Melanoma Tumor Depth Quality Audit: A Nonmatch Analysis. J Registry Manag 2021; 48:161-167. [PMID: 37260866 PMCID: PMC10198396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Background The National Cancer Institute's Surveillance Research Program (SRP) received reports from cancer registries in the Surveillance, Epidemiology, and End Results (SEER) Program concerning the coding of melanoma tumor depth. To address these concerns, SRP developed an algorithm to identify melanoma depth measurement values and conducted a nonmatch analysis. Methods A nonmatch analysis was conducted on 1,117 cases diagnosed between 2010 and 2017. With the help of Information Management Services, a natural language processing algorithm was developed to identify melanoma tumor depth values along with a gold standard for comparison. A randomly sampled data set was created to compare the algorithm-generated and gold standard values to the originally reported values; these were analyzed using SAS software version 9.4. Analyses were conducted to determine the distribution of nonmatches by demographics and estimate the distribution of nonmatches by the derived T variable according to the 7th edition of the American Joint Committee on Cancer (AJCC)'s AJCC Cancer Staging Manual. Results Of the 1,117 cases, 849 cases (76%) were a match between the originally reported values and the gold standard. The majority of cases were found to be in male patients (60%) and non-Hispanic White patients (93%). When comparing derived AJCC-7 T based on the originally reported value to the gold standard, 16% of the original derived AJCC-7 T values were incorrect, with most of the nonmatches resulting in incorrectly coding a case as TX instead of T1. Conclusion In total, 24% of cases were found to have a discrepancy in the originally recorded values. Decimal errors made up 3% of all cases in this nonmatch analysis. This algorithm may prove to be an essential tool in optimizing registry resources by flagging inconsistencies via automated text review to be adjudicated by registrars, improving their quality of data as needed.
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Affiliation(s)
- Pamela Sanchez
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Margaret (Peggy) Adamo
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Clara J.K. Lam
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | | | - Ariel Brest
- Information Management Services, Calverton, Maryland
| | - Serban Negoita
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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9
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Aguilar-Romero E, Chávez-Hernández JD, Zepeda-Najar C, Salcedo-Hernández RA, Lino-Silva LS. Prognostic variables in patients with thick melanomas. Analysis of 362 cases. GAC MED MEX 2021; 157:207-211. [PMID: 34270542 DOI: 10.24875/gmm.m21000543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/16/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Melanoma epidemiological and prognostic studies are based on Caucasian populations, in whom the predominant subtype is superficially-spreading melanoma and in whom thin melanomas (Breslow < 3 mm) predominate. Mexican patients show a predominance of thick melanomas (Breslow ≥ 3 mm), and the acral subtype is the most common. There are no publications on prognostic factors in thick melanomas. We hypothesize that we will identify factors that determine the prognosis in this group of patients. OBJECTIVE To identify clinical-pathological factors associated with the prognosis of patients with thick melanomas in the Mexican population. MATERIAL AND METHODS Data on melanomas with Breslow > 3 mm were collected from 2010 to 2015. The prognostic influence of various clinical-pathological factors was analyzed. RESULTS The most common subtypes were acral melanoma in 271 patients (74.9 %) and nodular melanoma in 49 (13.5 %). Median Breslow thickness was 7 mm. 56.6 % of the patients had lymph node metastases (clinical stage [CS] III), 269 (74.3 %) had ulceration, and surgical margins were positive in 15 (4.1 %). Elevated neutrophil: lymphocyte ratio (≥ 2) was found in 188 (51.9 %). The variables associated with lower overall survival were CS (p < 0.001), Breslow thickness (p = 0.044), ulceration (p = 0.004), mitotic activity (p < 0.001), < 2-cm margin (p < 0.001) and an increased neutrophil: lymphocyte ratio (p = 0.037). In the multivariate analysis, the factors associated with overall survival were CS, mitotic activity, and surgical margin. CONCLUSIONS In patients with thick melanomas, overall survival is influenced by mitotic activity, a positive margin, and clinical stage.
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Affiliation(s)
- Estefanía Aguilar-Romero
- Department of Pathological Anatomy, Instituto Nacional de Cancerología, Mexico City
- AFINES Program, Universidad Nacional Autónoma de México, Mexico City
| | | | - César Zepeda-Najar
- Department of Surgical Oncology, Hospital Ángeles Tijuana, Tijuana, Baja California Norte
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Martínez-Piva MM, Vacas AS, Rodríguez Kowalczuk MV, Gallo F, Rodrígues Vasconcelos M, Mazzuoccolo LD. Dermoscopy as a Tool for Estimating Breslow Thickness in Melanoma. Actas Dermosifiliogr (Engl Ed) 2021; 112:434-40. [PMID: 33259813 DOI: 10.1016/j.ad.2020.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The incidence of melanoma has increased significantly, and early diagnosis is the most effective way to reduce associated deaths. Dermoscopy increases diagnostic accuracy in melanoma and analysis of dermoscopic structures can help in the estimation of tumor thickness. The aim of this study was to analyze the influence of Breslow thickness on the dermoscopic characteristics of melanoma. MATERIAL AND METHODS Observational, cross-sectional study of patients with histologically confirmed melanoma and dermoscopic images of the tumor. The patients were divided into three groups: melanoma in situ, thin melanoma (≥ 1 mm Breslow thickness), and thick melanoma (≥ 1 mm Breslow thickness). Age, sex, tumor location, and histologic and dermoscopic characteristics were analyzed in all cases. RESULTS We studied 215 patients: 88 with melanoma in situ, 73 with thin melanoma, and 54 with thick melanoma. The frequency of the following dermoscopic features increased with increasing Breslow thickness: the blue-white veil (p < 0.001), white shiny structures (p < 0.001), and milky-red areas (p < 0.003). Angulated lines, by contrast, became less common with increasing thickness (p < 0.002). CONCLUSIONS Dermoscopy not only improves diagnostic accuracy for pigmented lesions but also helps in the preoperative assessment of Breslow thickness in melanoma.
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Navarrete-Dechent C, Aleissa S, Connolly K, Hibler BP, Dusza SW, Rossi AM, Lee E, Nehal KS. Clinical size is a poor predictor of invasion in melanoma of the lentigo maligna type. J Am Acad Dermatol 2020; 84:1295-1301. [PMID: 33096134 DOI: 10.1016/j.jaad.2020.10.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 09/28/2020] [Accepted: 10/15/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND There are no well-defined clinical factors to predict the risk of occult invasion in melanoma of the lentigo maligna type (LM) before complete histopathologic analysis. OBJECTIVE To evaluate whether clinical size was a predictor of invasion in LM and subclinical extension. METHODS Consecutive cases of LM were recorded in a prospectively maintained database from 2006 to 2019. Patient and tumor data were recorded during initial evaluation. The LM clinical area was calculated in square millimeters (length × width). All patients were treated with staged excision. RESULTS We included 600 patients. The mean age was 65.9 years (standard deviation, 12.3; range, 27-95 years); 62.8% (n = 377) were men. The mean LM clinical area was 128.32 mm2 for in situ lesions versus 200.14 mm for invasive lesions (P = .1). Based on quantile regression, the median margin required for complete removal increased with LM clinical area. LIMITATIONS The study was performed in a tertiary cancer center with possible referral bias and more complex cases. CONCLUSIONS LM can present with variable clinical size, which may correlate with subclinical extension; however, the presence of invasion is not well estimated by LM clinical area.
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Affiliation(s)
- Cristian Navarrete-Dechent
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Saud Aleissa
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Karen Connolly
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Brian P Hibler
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Stephen W Dusza
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anthony M Rossi
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York
| | - Erica Lee
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kishwer S Nehal
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
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12
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Gualdi G, Panarese F, Meogrossi G, Marchioni M, De Tursi M, Di Marino P, Angelucci D, Amatetti M, Proietto G, Di Nicola M, Amerio P. Speed rate (SR) as a new dynamic index of melanoma behavior. Pigment Cell Melanoma Res 2020; 33:709-718. [PMID: 32406598 DOI: 10.1111/pcmr.12890] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 01/25/2023]
Abstract
Melanomas are skin tumors that show a variety of biological behavior. Some develop very fast and some other grow extremely slow, with metastasis appearing, eventually, many years after the diagnosis. The number of mitoses in primary melanoma has been related to a more aggressive tumor and may have a potential as predictive factor for cutaneous melanoma survival. However, tumor mitotic rate is a static measure and in multivariate analysis on tumor survival, it has scored less than other tumor characteristics. We tried to evolve tumor mitotic rate from a static parameter to a time-dependent one. Similar to the already described growth rate (GR), we propose the speed rate (SR). SR is defined as the ratio of tumor mitotic rate to time to melanoma development. A prospective series of 345 patients with melanoma was investigated for the role of SR as predictive factor for sentinel lymph node (SLN) positivity and tumor progression. We calculated the best threshold for SR and GR to predict the risk of recurrence. Melanoma clinical and histological characteristics as well as GR were correlated in a multivariated analysis with SR. SR values >0.2 mitoses/month were associated with negative prognostic factors such as ulceration (82.8%), SLN positivity (80%), progression (82.8%), and death (85.7%). The association of GR > 0.3 mm/months and SR > 0.2 mitoses/month had a significant predictive value in terms of SLN positivity, progression, and recurrence-free survival. We propose SR as a new "dynamic" predictor of histological SLN positivity and melanoma recurrence risk. We think that he association with this new feature with GR may be helpful in improving the accuracy of predicted clinical outcome of patient especially with thin melanomas.
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Affiliation(s)
- Giulio Gualdi
- Dermatologic Clinic, Department of Medicine and Aging Science, University G D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Fabrizio Panarese
- Dermatologic Clinic, Department of Medicine and Aging Science, University G D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Giovanna Meogrossi
- Dermatologic Clinic, Department of Medicine and Aging Science, University G D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Michele Marchioni
- Biostatistic, Department of Medical, Oral and Biotechnological Sciences, University G D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Michele De Tursi
- Oncologi Clinic, Department of Medical, Oral Sciences and Biotechnologies University G D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Pietro Di Marino
- Oncologi Clinic, Department of Medical, Oral Sciences and Biotechnologies University G D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Domenico Angelucci
- Dermatologic Clinic, Department of Medicine and Aging Science, University G D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Massimo Amatetti
- Dermatologic Clinic, Department of Medicine and Aging Science, University G D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Gianluca Proietto
- Dermatologic Clinic, Department of Medicine and Aging Science, University G D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Marta Di Nicola
- Biostatistic, Department of Medical, Oral and Biotechnological Sciences, University G D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Paolo Amerio
- Dermatologic Clinic, Department of Medicine and Aging Science, University G D'Annunzio Chieti-Pescara, Chieti, Italy
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Ghasemi Basir HR, Alirezaei P, Ahovan S, Moradi A. The relationship between mitotic rate and depth of invasion in biopsies of malignant melanoma. Clin Cosmet Investig Dermatol 2018; 11:125-130. [PMID: 29588608 PMCID: PMC5858543 DOI: 10.2147/ccid.s158043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Malignant melanoma of the skin is a potentially lethal neoplasm that generally originates from atypical melanocytes in the dermal-epidermal junction. When the neoplasm penetrates into the dermis, several variables can affect the extent of its spread, among which depth of invasion has the most important prognostic value. Mitotic rate is another prognostic factor that reflects the biological behavior of the neoplasm. Objective This study was designed to evaluate the probable relationship between the depth of invasion of malignant melanoma and its mitotic rate. Materials and methods This study was performed on 50 excisional biopsy specimens that had received the diagnosis of malignant melanoma histopathologically. Tumor characteristics including Breslow thickness, Clark level, T-stage, and tumor mitotic rate were recorded. Results We observed that at higher Clark levels and higher T-stages, and the mean mitotic rate was significantly increased. Moreover, there was a positive and significant correlation between Breslow thickness and mitotic rate. We demonstrated that one unit increase in mitotic rate was correlated with 0.8 mm increase in Breslow thickness of the tumor. Conclusion In malignant melanoma, mitotic activity may probably indicate the depth of tumor invasion. Therefore, in incisional biopsies where depth of invasion cannot be accurately determined, the mitotic activity may be used to estimate Breslow thickness, which is necessary for planning surgical management.
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Affiliation(s)
- Hamid Reza Ghasemi Basir
- Department of Pathology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,Psoriasis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Pedram Alirezaei
- Psoriasis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sara Ahovan
- School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abbas Moradi
- School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Galasso M, Morrison C, Minotti L, Corrà F, Zerbinati C, Agnoletto C, Baldassari F, Fassan M, Bartolazzi A, Vecchione A, Nuovo GJ, Di Leva G, D'Atri S, Alvino E, Previati M, Nickoloff BJ, Croce CM, Volinia S. Loss of miR-204 expression is a key event in melanoma. Mol Cancer 2018; 17:71. [PMID: 29523154 DOI: 10.1186/s12943-018-0819-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Cutaneous melanoma (CM) is a malignancy with increasing occurrence. Its microRNA repertoire has been defined in a number studies, leading to candidates for biological and clinical relevance: miR-200a/b/c, miR-203, miR-205, miR-204, miR-211, miR-23b and miR-26a/b. Our work was aimed to validate the role of these candidate miRNAs in melanoma, using additional patients cohorts and in vitro cultures. miR-26a, miR-204 and miR-211 were more expressed in normal melanocytes, while miR-23b, miR-200b/c, miR-203 and miR-205 in epidermis and keratinocytes. None of the keratinocyte-related miRNAs was associated with any known mutation or with clinical covariates in melanoma. On the other hand, the loss of miR-204 was enriched in melanomas with NRAS sole mutation (Fisher exact test, P = 0.001, Log Odds = 1.67), and less frequent than expected in those harbouring CDKN2A mutations (Fisher exact test, P = 0.001, Log Odds - 1.09). Additionally, miR-204 was associated with better prognosis in two independent melanoma cohorts and its exogenous expression led to growth impairment in melanoma cell lines. Thus, miR-204 represents a relevant mechanism in melanoma, with potential prognostic value and its loss seems to act in the CDKN2A pathway, in cooperation with NRAS.
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15
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Sacchetto L, Zanetti R, Comber H, Bouchardy C, Brewster DH, Broganelli P, Chirlaque MD, Coza D, Galceran J, Gavin A, Hackl M, Katalinic A, Larønningen S, Louwman MWJ, Morgan E, Robsahm TE, Sanchez MJ, Tryggvadóttir L, Tumino R, Van Eycken E, Vernon S, Zadnik V, Rosso S. Trends in incidence of thick, thin and in situ melanoma in Europe. Eur J Cancer 2018; 92:108-118. [PMID: 29395684 DOI: 10.1016/j.ejca.2017.12.024] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 12/14/2017] [Accepted: 12/21/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND We analysed trends in incidence for in situ and invasive melanoma in some European countries during the period 1995-2012, stratifying for lesion thickness. MATERIAL AND METHODS Individual anonymised data from population-based European cancer registries (CRs) were collected and combined in a common database, including information on age, sex, year of diagnosis, histological type, tumour location, behaviour (invasive, in situ) and lesion thickness. Mortality data were retrieved from the publicly available World Health Organization database. RESULTS Our database covered a population of over 117 million inhabitants and included about 415,000 skin lesions, recorded by 18 European CRs (7 of them with national coverage). During the 1995-2012 period, we observed a statistically significant increase in incidence for both invasive (average annual percent change (AAPC) 4.0% men; 3.0% women) and in situ (AAPC 7.7% men; 6.2% women) cases. DISCUSSION The increase in invasive lesions seemed mainly driven by thin melanomas (AAPC 10% men; 8.3% women). The incidence of thick melanomas also increased, although more slowly in recent years. Correction for lesions of unknown thickness enhanced the differences between thin and thick cases and flattened the trends. Incidence trends varied considerably across registries, but only Netherlands presented a marked increase above the boundaries of a funnel plot that weighted estimates by their precision. Mortality from invasive melanoma has continued to increase in Norway, Iceland (but only for elder people), the Netherlands and Slovenia.
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Affiliation(s)
- L Sacchetto
- Piedmont Cancer Registry, A.O.U, Città della Salute e della Scienza di Torino, Turin, Italy; Politecnico di Torino, Turin, Italy; Università degli Studi di Torino, Turin, Italy.
| | - R Zanetti
- Piedmont Cancer Registry, A.O.U, Città della Salute e della Scienza di Torino, Turin, Italy
| | - H Comber
- National Cancer Registry Ireland, Ireland
| | | | | | - P Broganelli
- A.O.U, Città della Salute e della Scienza di Torino, Turin, Italy
| | - M D Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, CIBERESP, Spain
| | - D Coza
- Cluj Regional Cancer Registry, Oncology Institute Cluj, Romania
| | - J Galceran
- Tarragona Cancer Registry, Foundation Society for Cancer Research and Prevention, (FUNCA), Pere Virgili Health Research Institute (IISPV), Reus, Spain
| | - A Gavin
- Northern Ireland Cancer Registry, Queens University Belfast, Belfast, UK
| | - M Hackl
- Austrian National Cancer Registry, Wien, Austria
| | - A Katalinic
- Institute for Social Medicine and Epidemiology, University Lübeck, Lubeck, Germany
| | - S Larønningen
- Cancer Registry of Norway, Institute of Population Based Cancer Research, Oslo, Norway
| | - M W J Louwman
- Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
| | - E Morgan
- Northern Ireland Cancer Registry, Queens University Belfast, Belfast, UK
| | - T E Robsahm
- Cancer Registry of Norway, Institute of Population Based Cancer Research, Oslo, Norway
| | - M J Sanchez
- Escuela Andaluza de Salud Pública, CIBER de Epidemiología y Salud Pública, (CIBERESP), Ibs, Granada, Spain
| | - L Tryggvadóttir
- Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland
| | - R Tumino
- Cancer Registry and Histopathology Department, "Civic - M.P.Arezzo" Hospital, ASP, Ragusa, Italy
| | | | - S Vernon
- National Cancer Registration Service - Public Health England, Cambridge, UK
| | - V Zadnik
- Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - S Rosso
- Piedmont Cancer Registry, A.O.U, Città della Salute e della Scienza di Torino, Turin, Italy
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Bernardes SS, de Souza-Neto FP, Ramalho LNZ, Derossi DR, Guarnier FA, da Silva CFN, Melo GP, Simão ANC, Cecchini R, Cecchini AL. Systemic oxidative profile after tumor removal and the tumor microenvironment in melanoma patients. Cancer Lett 2015; 361:226-32. [PMID: 25772650 DOI: 10.1016/j.canlet.2015.03.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 03/05/2015] [Accepted: 03/06/2015] [Indexed: 02/09/2023]
Abstract
This study highlights the systemic oxidative changes in patients submitted to primary cutaneous melanoma removal. Cutaneous melanoma is highly aggressive and its incidence is increasing worldwide. We evaluated systemic oxidative stress (OS) and 3-nitrotyrosine (3-NT) expression in melanoma tissue in relation to the Breslow thickness in patients under surveillance. Forty-three patients with cutaneous melanoma and 50 healthy volunteers were recruited. Patients were divided into two groups according to the tumor's Breslow thickness: T1/T2 (<2 mm) and T3/T4 (≥2 mm). Systemic OS and inflammatory mediators were evaluated in plasma, and the 3-NT expression was analyzed via immunohistochemistry. Compared with the controls, the patients had lower blood levels of reduced glutathione, higher malondialdehyde and thiol levels, and a higher total radical-trapping antioxidant parameter to uric acid ratio. The C-reactive protein and γ-glutamyl transpeptidase were increased only in the T3/T4 group. High levels of 3-NT were present only in T3/T4 patients. Our data suggested that a correlation exists between the Breslow thickness and a systemic pro-oxidant status, and that oxidative changes induced by the melanoma remain in the microenvironment post-surgery, demonstrating a role for oxygen species in melanoma.
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Affiliation(s)
- Sara Santos Bernardes
- Laboratory of Molecular Pathology, Department of General Pathology, State University of Londrina, PR445, Km 380, Londrina, PR 86057-970, Brazil
| | - Fernando Pinheiro de Souza-Neto
- Laboratory of Molecular Pathology, Department of General Pathology, State University of Londrina, PR445, Km 380, Londrina, PR 86057-970, Brazil
| | - Leandra Náira Zambelli Ramalho
- Department of Pathology and Legal Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Av Bandeirantes, 3900, Ribeirão Preto, SP 14049-900, Brazil
| | - Daniela Rudgeri Derossi
- Londrina Cancer Hospital, Rua Lucilla Ballalai, 212, Londrina, PR 86015-520, Brazil; Department of Pathology, Clinical and Toxicological Analysis, University Hospital, State University of Londrina, Av. Robert Koch, 60, Londrina, PR 86038-350, Brazil
| | - Flávia Alessandra Guarnier
- Department of Pathology and Legal Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Av Bandeirantes, 3900, Ribeirão Preto, SP 14049-900, Brazil
| | - Cássio Fernando Nunes da Silva
- Laboratory of Molecular Pathology, Department of General Pathology, State University of Londrina, PR445, Km 380, Londrina, PR 86057-970, Brazil
| | - Gabriella Pascoal Melo
- Laboratory of Molecular Pathology, Department of General Pathology, State University of Londrina, PR445, Km 380, Londrina, PR 86057-970, Brazil
| | - Andréa Name Colado Simão
- Department of Pathology, Clinical and Toxicological Analysis, University Hospital, State University of Londrina, Av. Robert Koch, 60, Londrina, PR 86038-350, Brazil
| | - Rubens Cecchini
- Laboratory of Pathophysiology and Free Radicals, Department of General Pathology, State University of Londrina, PR445, Km 380, Londrina, PR 86057-970, Brazil
| | - Alessandra Lourenço Cecchini
- Laboratory of Molecular Pathology, Department of General Pathology, State University of Londrina, PR445, Km 380, Londrina, PR 86057-970, Brazil.
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Tarwate M, Benchikhi H, Adarmouch L, Benider A, Amine M, Zamiati S, Boukind EH. [Thick cutaneous melanoma: mortality factors and occurrence of metastases]. Pan Afr Med J 2014; 18:44. [PMID: 25368733 PMCID: PMC4215361 DOI: 10.11604/pamj.2014.18.44.2812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 12/12/2013] [Indexed: 12/02/2022] Open
Abstract
Au Maroc peu d’études ont été menées concernant les facteurs pronostiques du mélanome. L'objectif de cette étude était d'identifier les facteurs de survenue de métastases viscérales à distance à 1an et de mortalité à 2ans chez des patients atteints de mélanome cutané épais. Ont été colligés rétrospectivement tous les cas de mélanomes suivis au service de dermatologie et d'oncologie du CHU de Casablanca de 2006 à 2010. On été inclus les patients qui présentaient un mélanome à localisation cutanée et/ou muqueuse buccogénitale, confirmés histologiquement ayant un Breslow>2mm. Ont été exclus les patients présentant des métastases viscérales à distance au moment du diagnostic. Les données socio-démographiques, cliniques et thérapeutiques ont été recueillies au niveau des dossiers; celles relatives à l’évolution ont été complétées par contact téléphonique. L'analyse statistique était de type uni et bivarié. Soixante patients ont été inclus:41hommes et19femmes (sexe ratio de 2,15). La moyenne d’âge était de 60 ans (17-96). L'indice de Breslow était en moyenne de10mm+/-7et78%des patients(32) avaient un Breslow>4mm. Vingt trois patients (38,3%) avaient des adénopathies régionales. Quatorze patients ont présenté des métastases à distance après 1an (23,3%) et13patients étaient décédés après 2ans d’évolution (21,7%). Les facteurs associés à la survenue de métastases à distance étaient l'indice de Breslow. Des métastases à 1an ont été retrouvées chez 61,5%des patients avec un Breslow >10mm contre18,8% avec un Breslow
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Affiliation(s)
- Mariam Tarwate
- Service de dermatologie vénérologie CHU Ibn Rochd Casablanca
| | | | | | | | - Mohamed Amine
- Département de médecine communautaire CHU Mohamed VI Marrakech
| | | | - El Hassan Boukind
- Service de chirurgie plastique et réparatrice CHU Ibn Rochd Casablanca
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Abstract
OBJECTIVES The clinical significance of nevus-associated melanoma compared with de novo melanomas remains controversial. It has been suggested that nevus-associated melanomas have a higher Breslow thickness and therefore worse prognosis. Over a 10-year period, this study evaluated the incidence of nevus-associated melanoma and its prognostic significance related to clinicopathologic features. METHODS Cross-sectional study from 1995 through 2004 in a dermatopathology referral center. With available data, we evaluated sex, primary location, histologic subtype, Breslow thickness, Clark level, presence of ulceration, associated lesion, and histologic subtype of the associated lesion. RESULTS Of 135,653 pathologic records from skin biopsy specimens over a 10-year period, 1,190 melanoma records were selected. Nevus-associated melanomas corresponded to 390 (32.8%) melanomas, with thin melanomas having a nevus 1.52 times the association observed with thick melanomas (>1.01 mm; 95% confidence interval, 1.16-1.99; P < .001). Superficial spreading melanoma was the most frequent, while no lentigo maligna melanoma was associated with nevi. The median Breslow thickness of nevus-associated melanomas was lower than that of de novo melanomas. CONCLUSIONS Nevus-associated melanomas, which represent one-third of the melanomas in southeast Brazil, are associated with intermittent sun exposure, superficial spreading melanomas, and lower Breslow thickness. This is one of the largest series describing nevus-associated melanomas in Latin America.
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Affiliation(s)
- Danielle Shitara
- From the Department of Dermatology, Federal University of São Paulo, São Paulo, Brazil;
| | - Mauricio M Nascimento
- From the Department of Dermatology, Federal University of São Paulo, São Paulo, Brazil
| | - Susana Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic of Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain and CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spainand
| | - Sérgio Yamada
- From the Department of Dermatology, Federal University of São Paulo, São Paulo, Brazil
| | - Milvia M S S Enokihara
- From the Department of Dermatology, Federal University of São Paulo, São Paulo, Brazil; Department of Pathology, Federal University of São Paulo, São Paulo, Brazil
| | - Nilceo Michalany
- From the Department of Dermatology, Federal University of São Paulo, São Paulo, Brazil; Department of Pathology, Federal University of São Paulo, São Paulo, Brazil
| | - Ediléia Bagatin
- From the Department of Dermatology, Federal University of São Paulo, São Paulo, Brazil
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