دورية أكاديمية
Prognostic significance of regression and mitotic rate in head and neck cutaneous melanoma.
العنوان: | Prognostic significance of regression and mitotic rate in head and neck cutaneous melanoma. |
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المؤلفون: | Kim E; Department of Otolaryngology-Head and Neck Surgery University of Minnesota Minneapolis Minnesota USA., Obermeyer I; Department of Otolaryngology-Head and Neck Surgery University of Minnesota Minneapolis Minnesota USA., Rubin N; Biostatistics Core, Masonic Cancer Center University of Minnesota Minneapolis Minnesota USA., Khariwala SS; Department of Otolaryngology-Head and Neck Surgery University of Minnesota Minneapolis Minnesota USA. |
المصدر: | Laryngoscope investigative otolaryngology [Laryngoscope Investig Otolaryngol] 2020 Dec 16; Vol. 6 (1), pp. 109-115. Date of Electronic Publication: 2020 Dec 16 (Print Publication: 2021). |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Wiley Country of Publication: United States NLM ID: 101684963 Publication Model: eCollection Cited Medium: Print ISSN: 2378-8038 (Print) Linking ISSN: 23788038 NLM ISO Abbreviation: Laryngoscope Investig Otolaryngol Subsets: PubMed not MEDLINE |
أسماء مطبوعة: | Original Publication: [Hoboken, NJ] : Wiley, [2016]- |
مستخلص: | Importance: While regression is a commonly reported microscopic feature of melanoma, its prognostic significance is unclear. Objective: To examine the impact of regression on sentinel node status and the likelihood of recurrence in primary cutaneous melanoma of the head and neck. Design: Retrospective analysis of 191 adults who underwent surgical management for primary cutaneous melanoma of the head and neck between May 2002 and March 2019. Setting: Tertiary academic center. Participants: Patients appropriate for the study were identified by the Academic Health Center Information Exchange using a list of current procedural terminology codes. One hundred and ninety-one cases of invasive melanoma of the head and neck were included from 830 patients identified. Clinical features assessed for each patient included age, sex, location of primary lesion, date of diagnosis, and current disease status (alive with or without disease). Histologic features assessed were histological melanoma subtype (nodular vs non-nodular), Breslow thickness, Clark level, presence/absence of ulceration, mitotic rate per square millimeter, and regression. If applicable, sentinel lymph node biopsy (SLNB) status, date of recurrence, interval treatments, and date of death related to melanoma were recorded. Exclusion criteria included melanoma outside the anatomic parameters of head and neck, ocular or choroidal melanoma, mucosal melanoma, metastatic melanoma to the head or neck with no known primary tumor, melanoma of the head or neck with no surgical intervention, and non-melanoma skin cancers of the head and neck. Intervention/exposure: Surgery for cutaneous melanoma of the head and neck. Main Outcomes and Measures: The association between presence of regression and Breslow thickness, sentinel node status, and recurrence. Results: Of the 191 patients identified, 30.9% were female and 69.1% were male with a mean age at diagnosis of 62.6 (range 20-97) years. Mean Breslow thickness was 1.2 mm in those with regression and 2.0 mm in those without regression. In patients with regression, 17.6% had a positive sentinel node, and 13.0% experienced a recurrence. In patients without regression, 26.5% had a positive sentinel node, and 31.4% experienced a recurrence. When adjusted for other factors above, regression was not associated with positive sentinel node (odds ratio [OR] = 0.59, 95% confidence interval [CI] = 0.13-2.00) or recurrence (OR = 0.33, CI = 0.07-1.01). Mitotic rate >2 was associated with recurrence (OR = 2.71, CI = 1.11-6.75, P = .03). Conclusions and Relevance: Patients with presence of regression had thinner melanomas and trended toward decreased rates of sentinel node positivity and recurrence, suggesting regression may not be a negative prognostic indicator in patients with cutaneous melanoma of the head and neck. Competing Interests: The authors declare no potential conflict of interest. (© 2020 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC. on behalf of The Triological Society.) |
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معلومات مُعتمدة: | P30 CA077598 United States CA NCI NIH HHS; UL1 TR002494 United States TR NCATS NIH HHS |
تواريخ الأحداث: | Date Created: 20210222 Latest Revision: 20220420 |
رمز التحديث: | 20240628 |
مُعرف محوري في PubMed: | PMC7883603 |
DOI: | 10.1002/lio2.509 |
PMID: | 33614938 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2378-8038 |
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DOI: | 10.1002/lio2.509 |