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Progressive disease in sentinel-negative melanoma patients: biological differences and importance of sentinel lymph node biopsy


Conrad, Anna; Reinehr, Michael; Holzmann, David; Mangana, Joanna; Wanner, Miriam; Huellner, Martin; Barnhill, Raymond L; Lugassy, Claire; Lindenblatt, Nicole; Mihic-Probst, Daniela (2020). Progressive disease in sentinel-negative melanoma patients: biological differences and importance of sentinel lymph node biopsy. Anticancer Research, 40(2):891-899.

Abstract

BACKGROUND/AIM: Among the most important prognostic factors in melanoma is the sentinel lymph node (SLN) status.
MATERIALS AND METHODS: Using our electronic database we identified 109 of 890 SLN-negative patients with progressive disease (PD). These patients were characterized for melanoma type, molecular type, sequence and extent of metastatic spread.
RESULTS: A total of 61 of 109 SLN-negative patients had PD in the SLN-basin indicating false-negative SLN (group-1). Forty eight of 109 patients had PD at distant sites and were therefore impossible to be identified using SLN biopsy (group-2). Despite distant spread these patients had significantly more single organ metastasis (p<0.001) and significantly longer disease-free-survival (p=0.001) compared to group-1. Additionally, to significant differences on a molecular basis between the two groups (p=0.01), all lentigo maligna and spindle-cell-melanomas belonged to group-2 and all, except one lentigo maligna melanoma, had single visceral metastasis.
CONCLUSION: Two different biological groups among SLN-negative patients with PD were demonstrated. Extravascular-migratory-metastasis, rather than hematogenous spread, might be responsible for the observed PD with single organ involvement.

Abstract

BACKGROUND/AIM: Among the most important prognostic factors in melanoma is the sentinel lymph node (SLN) status.
MATERIALS AND METHODS: Using our electronic database we identified 109 of 890 SLN-negative patients with progressive disease (PD). These patients were characterized for melanoma type, molecular type, sequence and extent of metastatic spread.
RESULTS: A total of 61 of 109 SLN-negative patients had PD in the SLN-basin indicating false-negative SLN (group-1). Forty eight of 109 patients had PD at distant sites and were therefore impossible to be identified using SLN biopsy (group-2). Despite distant spread these patients had significantly more single organ metastasis (p<0.001) and significantly longer disease-free-survival (p=0.001) compared to group-1. Additionally, to significant differences on a molecular basis between the two groups (p=0.01), all lentigo maligna and spindle-cell-melanomas belonged to group-2 and all, except one lentigo maligna melanoma, had single visceral metastasis.
CONCLUSION: Two different biological groups among SLN-negative patients with PD were demonstrated. Extravascular-migratory-metastasis, rather than hematogenous spread, might be responsible for the observed PD with single organ involvement.

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Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Otorhinolaryngology
04 Faculty of Medicine > University Hospital Zurich > Institute of Pathology and Molecular Pathology
04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:February 2020
Deposited On:18 Mar 2020 14:50
Last Modified:26 Feb 2021 08:15
Publisher:International Institute of Anticancer Research
ISSN:0250-7005
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.21873/anticanres.14022
PubMed ID:32014933

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