The prognostic significance of microsatellites in cutaneous melanoma.

Mod Pathol 2020 Feb 13. Epub 2020 Feb 13.

Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.

Microscopic satellite metastases are an adverse prognostic feature in primary cutaneous melanoma patients. The prognostic significance of microsatellites, including their number, size and distance from the primary melanoma, using the 8th edition American Joint Committee on Cancer definition, has not previously been evaluated. This study sought to determine the prognostic significance of microsatellites in histopathologically reviewed cases. Eighty-seven cases of primary cutaneous melanoma with the presence of microsatellites documented in the original pathology report and all histopathology slides available were reviewed and the findings were correlated with clinical outcome. Matched control cases were selected for all confirmed microsatellites cases. The presence of microsatellites was confirmed in 69 cases. The microsatellite group had significantly worse prognosis, with 21% 5-year disease-free survival compared with 56% in the control group (p < 0.001). The 5-year melanoma-specific survival was 53% in the microsatellites group and 73% in the control group (p = 0.004). Increasing distance (mm) of the microsatellite from the primary melanoma was found to adversely influence disease-free survival (HR = 1.24, 95% CI: 1.13-1.36, p < 0.001), overall survival (HR = 1.26 95%CI: 1.13-1.40, p < 0.001), and melanoma-specific survival (HR = 1.27 95% CI: 1.11-1.45, p < 0.001). Number and size of microsatellites were not significant prognostic factors. The presence of microsatellites was the only factor that proved to be an independent predictor of sentinel node positivity in multivariate analysis (OR 4.64; 95% CI 1.66-12.95; p = 0.003). Microsatellites were significantly associated with more loco-regional recurrences (p < 0.001) but not distant metastases (p = 0.821). Melanomas with microsatellites as defined by the 8th edition American Joint Committee on Cancer staging system are thus aggressive tumors, associated with significantly worse disease-free survival, overall survival and melanoma-specific survival. The presence of microsatellites is also associated with sentinel node-positivity and local and in-transit recurrence. Increasing distance of the microsatellite from the primary tumor is an independent adverse prognostic factor that warrants further evaluation.

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41379-020-0500-9DOI Listing
February 2020

Publication Analysis

Top Keywords

significance microsatellites
12
prognostic significance
12
cutaneous melanoma
12
primary cutaneous
8
presence microsatellites
8
microsatellites
6
cases
5
prognostic
4
cases eighty-seven
4
reviewed cases
4
cases primary
4
melanoma presence
4
histopathologically reviewed
4
eighty-seven cases
4
sought determine
4
group worse
4
definition evaluated
4
cancer definition
4
control cases
4
evaluated study
4

References

(Supplied by CrossRef)

JE Gershenwald et al.
CA Cancer J Clin 2017

CM Balch et al.
J Clin Oncol 2009

JW Kelly et al.
Ann Surg 1984

TF Kimsey et al.
Ann Surg Oncol 2009

S Mocellin et al.
Ann Surg Oncol 2006

S Mraz-Gernhard et al.
Arch Dermatol 1998

E Nagore et al.
Melanoma Res 2005

UN Rao et al.
J Clin Oncol 2002

L Shaikh et al.
Arch Dermatol 2005

A Tejera-Vaquerizo et al.
Actas Dermosifiliogr 2011

Similar Publications