Analysis of Sentinel Node Biopsy and Clinicopathologic Features as Prognostic Factors in Patients With Atypical Melanocytic Tumors.
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Maurichi Andrea, Miceli Rosalba, Patuzzo Roberto, Barretta Francesco, Gallino Gianfranco, Mattavelli Ilaria, Barbieri Consuelo, Leva Andrea, Cortinovis Umberto, Tolomio Elena, Sant Milena, Castelli Gianpiero, Zichichi Leonardo, Pellacani Giovanni, Stanganelli Ignazio, Simonacci Marco, Manganoni Ausilia, Del Forno Corrado, Caresana Gioachino, Harwood Catherine, Bergamaschi Daniele, Lasithiotakis Konstantinos, Bennett Dorothy, Espeli Vittoria, Mangas Cristina, Leoni Parvex Sandra, Valeri Barbara, Cossa Mara, Barisella Marta, Pellegrinelli Alessandro, Miranda Claudia, Anichini Andrea, Mortarini Roberta, Zoras Odysseas, Santinami Mario
Аннотация
PATIENTS AND METHODS: Clinicopathologic and follow-up data of 238 children, adolescents, and adults with histologically proved AMTs consecutively treated at 12 European centers from 2000 through 2010 were retrieved from prospectively maintained databases. The binary association between all investigated covariates was studied by evaluating the Spearman correlation coefficients, and the association between progression-free survival and all investigated covariates was evaluated using univariable Cox models. The overall survival and progression-free survival curves were established using the Kaplan-Meier method.
RESULTS: Median follow-up was 126 months (interquartile range, 104-157 months). All patients received an initial diagnostic biopsy followed by wide (1 cm) excision. Sentinel node biopsy was performed in 139 patients (58.4%), 37 (26.6%) of whom had sentinel node positivity. There were 4 local recurrences, 43 regional relapses, and 8 distant metastases as first events. Six patients (2.5%) died of disease progression. Five patients who were sentinel node-negative and 3 patients who were sentinel node-positive developed distant metastases. Ten-year overall and progression-free survival rates were 97% (95% CI, 94.9%-99.2%) and 82.2% (95% CI, 77.3%-87.3%), respectively. Age, mitotic rate/mm2, mitoses at the base of the lesion, lymphovascular invasion, and 9p21 loss were factors affecting prognosis in the whole series and the sentinel node biopsy subgroup.
CONCLUSIONS: Age >20 years, mitotic rate >4/mm2, mitoses at the base of the lesion, lymphovascular invasion, and 9p21 loss proved to be worse prognostic factors in patients with ATMs. Sentinel node status was not a clear prognostic predictor.