Invasive Cutaneous Melanoma: Evaluating the Prognostic Significance of Some Parameters Associated with Lymph Node Metastases
<i>Background and Objectives</i>: This study aimed to assess the clinical-pathological profile of patients with invasive cutaneous melanomas and to identify the parameters with a prognostic role in the lymph nodal spread of this malignant tumor. <i>Materials and Methods</i>:...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-07-01
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| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/59/7/1241 |
| Summary: | <i>Background and Objectives</i>: This study aimed to assess the clinical-pathological profile of patients with invasive cutaneous melanomas and to identify the parameters with a prognostic role in the lymph nodal spread of this malignant tumor. <i>Materials and Methods</i>: We performed a retrospective study on patients with invasive cutaneous melanomas who underwent surgery in the “Pius Brînzeu” County Clinical Emergency Hospital from Timișoara, Romania, and were evaluated for the status of loco-regional lymph nodes. We selected and analyzed some parameters searching for their relationship with lymph node metastases. <i>Results</i>: We identified 79 patients with invasive cutaneous melanomas (29 men and 50 women, mean age 59.36 years). A percentage of 58.3% of melanomas had Breslow tumor thickness >2 mm; 69.6% of melanomas showed a Clark level IV–V. Tumor ulceration was present in 59.5% of melanomas. A mitotic rate of ≥5 mitoses/mm<sup>2</sup> was observed in 48.1% of melanomas. Tumor-infiltrating lymphocytes (TILs), non-brisk, were present in 59.5% of cases and 22.8% of patients had satellite/in-transit metastasis (SINTM). Tumor regression was identified in 44.3% of cases. Lymph nodes metastases were found in 43.1% of patients. Statistical analysis showed that lymph node metastases were more frequent in melanomas with Breslow thickness >2 mm (<i>p</i> = 0.0002), high Clark level (<i>p</i> = 0.0026), mitotic rate >5 mitoses/mm<sup>2</sup> (<i>p</i> = 0.0044), ulceration (<i>p</i> = 0.0107), lymphovascular invasion (<i>p</i> = 0.0182), SINTM (<i>p</i> = 0.0302), and non-brisk TILs (<i>p</i> = 0.0302). <i>Conclusions</i>: The Breslow thickness >2 mm, high Clark level, high mitotic rate and ulceration are the most important prognostic factors for lymph nodal spread in cutaneous melanomas. However, some melanomas without these clinical-pathological features can have an unexpected, aggressive evolution, which entails the necessity of close and prolonged clinical follow-up of patients, including those with lesions considered without risk. |
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| ISSN: | 1010-660X 1648-9144 |