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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2019

01-01-2019 | Melanoma

Microsatellitosis in Patients with Melanoma

Authors: Giorgos C. Karakousis, MD, Phyllis A. Gimotty, PhD, Stanley P. Leong, MD, Barbara A. Pockaj, MD, Richard L. White, MD, Cristina O’Donoghue, MD, MPH, Andrew J. Sinnamon, MD, MSCE, Edmund K. Bartlett, MD, Amylou C. Dueck, PhD, Bonnie E. Gould Rothberg, MD, PhD, MPH, Jane L. Messina, MD, John T. Vetto, MD, Vernon K. Sondak, MD, Schlomo Schneebaum, MD, Mohammed Kashani-Sabet, MD, Dale Han, MD, Mark B. Faries, MD, Jonathan S. Zager, MD, with the Sentinel Lymph Node Working Group

Published in: Annals of Surgical Oncology | Issue 1/2019

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Abstract

Background

Microsatellitosis (mS) in melanoma has been considered a marker of unfavorable tumor biology, leading to the current American Joint Committee on Cancer staging of IIIB/C/D disease, despite few investigative studies of this entity limited by the small sample sizes and incomplete nodal microstaging. We sought to better characterize outcomes and prognostic factors in a multi-institutional cohort of patients with mS and nodal microstaging.

Methods

The Sentinel Lymph Node Working Group cohort included 414 mS patients who underwent sentinel lymph node (SLN) biopsy. Cox regression analysis was used to evaluate the prognostic significance of established clinicopathologic characteristics. Melanoma-specific survival (MSS) of patients with mS was compared with 3002 similarly staged patients from the Surveillance, Epidemiology, and End Results (SEER) Program registry.

Results

The median age of the mS cohort was 64.9 years; 39.6% were female. Median thickness was 3 mm, 40.6% of cases were ulcerated, and the SLN positivity rate was 46.7%. Increasing thickness, male sex, and SLN positivity were significantly associated with poorer MSS. Stage IIIB/C/D 5-year MSS rates were 86.3% (95% confidence interval [CI] 79.4–93.3%), 54.1% (95% CI 45.4–59.7%), and 44.2% (95% CI 25.4–63.0%), respectively. MSS survival for the stage IIIB mS cohort was significantly better than a similarly staged SEER cohort (5-year MSS of 70.1%, 95% CI 66.0–74.2%), while no significant difference was observed for the stage IIIC or D cohorts.

Conclusions

SLN metastases are common and are a significant prognostic factor in patients with mS. Survival in stage IIIB patients with mS was considerably more favorable than their stage would otherwise suggest, which has important implications for decisions regarding adjuvant therapy for patients with mS.
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Literature
1.
Day CL Jr, Harrist TJ, Gorstein F, et al. Malignant melanoma. Prognostic significance of “microscopic satellites” in the reticular dermis and subcutaneous fat. Ann Surg. 1981;194(1):108–112.CrossRefPubMedPubMedCentral
2.
Balch CM, Buzaid AC, Soong SJ, et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol. 2001;19(16):3635–3648.CrossRefPubMed
3.
Harrist TJ, Rigel DS, Day CL Jr, et al. “Microscopic satellites” are more highly associated with regional lymph node metastases than is primary melanoma thickness. Cancer. 1984;53(10):2183–2187.CrossRefPubMed
4.
Leon P, Daly JM, Synnestvedt M, Schultz DJ, Elder DE, Clark WH Jr. The prognostic implications of microscopic satellites in patients with clinical stage I melanoma. Arch Surg. 1991;126(12):1461–1468.CrossRefPubMed
5.
Kelly JW, Sagebiel RW, Calderon W, Murillo L, Dakin RL, Blois MS. The frequency of local recurrence and microsatellites as a guide to reexcision margins for cutaneous malignant melanoma. Ann Surg. 1984;200(6):759–763.CrossRefPubMedPubMedCentral
6.
Nagore E, Oliver V, Botella-Estrada R, Moreno-Picot S, Insa A, Fortea JM. Prognostic factors in localized invasive cutaneous melanoma: high value of mitotic rate, vascular invasion and microscopic satellitosis. Melanoma Res. 2005;15(3):169–177.CrossRefPubMed
7.
Rao UN, Ibrahim J, Flaherty LE, Richards J, Kirkwood JM. Implications of microscopic satellites of the primary and extracapsular lymph node spread in patients with high-risk melanoma: pathologic corollary of Eastern Cooperative Oncology Group Trial E1690. J Clin Oncol. 2002;20(8):2053–2057.CrossRefPubMed
8.
Shaikh L, Sagebiel RW, Ferreira CM, Nosrati M, Miller JR 3rd, Kashani-Sabet M. The role of microsatellites as a prognostic factor in primary malignant melanoma. Arch Dermatol. 2005;141(6):739–742.CrossRefPubMed
9.
Gershenwald JE, Scolyer RA, Hess KR, et al. Melanoma staging: Evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin. 2017;67(6):472–492.CrossRefPubMedPubMedCentral
10.
Chang JM, Kosiorek HE, Dueck AC, et al. Stratifying SLN incidence in intermediate thickness melanoma patients. Am J Surg. 2018;215(4):699–706.CrossRefPubMed
11.
Cordeiro E, Gervais MK, Shah PS, Look Hong NJ, Wright FC. Sentinel lymph node biopsy in thin cutaneous melanoma: a systematic review and meta-analysis. Ann Surg Oncol. 2016;23(13):4178–4188.CrossRefPubMed
12.
Azimi F, Scolyer RA, Rumcheva P, et al. Tumor-infiltrating lymphocyte grade is an independent predictor of sentinel lymph node status and survival in patients with cutaneous melanoma. J Clin Oncol. 2012;30(21):2678–2683.CrossRefPubMed
13.
Balch CM. Microscopic satellites around a primary melanoma: another piece of the puzzle in melanoma staging. Ann Surg Oncol. 2009;16(5):1092–1094.CrossRefPubMed
14.
Kimsey TF, Cohen T, Patel A, Busam KJ, Brady MS. Microscopic satellitosis in patients with primary cutaneous melanoma: implications for nodal basin staging. Ann Surg Oncol. 2009;16(5):1176–1183.CrossRefPubMed
15.
Sondak VK, Taylor JM, Sabel MS, et al. Mitotic rate and younger age are predictors of sentinel lymph node positivity: lessons learned from the generation of a probabilistic model. Ann Surg Oncol. 2004;11(3):247–258.CrossRefPubMed
16.
Spatz A, Shaw HM, Crotty KA, Thompson JF, McCarthy SW. Analysis of histopathological factors associated with prolonged survival of 10 years or more for patients with thick melanomas (> 5 mm). Histopathology. 1998;33(5):406–413.CrossRefPubMed
17.
Weide B, Faller C, Buttner P, et al. Prognostic factors of melanoma patients with satellite or in-transit metastasis at the time of stage III diagnosis. PLoS ONE. 2013;8(4):e63137.CrossRefPubMedPubMedCentral
18.
Zettersten E, Sagebiel RW, Miller JR, 3rd, Tallapureddy S, Leong SP, Kashani-Sabet M. Prognostic factors in patients with thick cutaneous melanoma (> 4 mm). Cancer. 2002;94(4):1049–1056.CrossRefPubMed
19.
Bartlett EK, Gupta M, Datta J, et al. Prognosis of patients with melanoma and microsatellitosis undergoing sentinel lymph node biopsy. Ann Surg Oncol. 2014;21(3):1016–1023.CrossRefPubMed
20.
21.
SAS Statistical Software version 9.4. Cary, NC: SAS Institute; 2013–2017.
Metadata
Title
Microsatellitosis in Patients with Melanoma
Authors
Giorgos C. Karakousis, MD
Phyllis A. Gimotty, PhD
Stanley P. Leong, MD
Barbara A. Pockaj, MD
Richard L. White, MD
Cristina O’Donoghue, MD, MPH
Andrew J. Sinnamon, MD, MSCE
Edmund K. Bartlett, MD
Amylou C. Dueck, PhD
Bonnie E. Gould Rothberg, MD, PhD, MPH
Jane L. Messina, MD
John T. Vetto, MD
Vernon K. Sondak, MD
Schlomo Schneebaum, MD
Mohammed Kashani-Sabet, MD
Dale Han, MD
Mark B. Faries, MD
Jonathan S. Zager, MD
with the Sentinel Lymph Node Working Group
Publication date
01-01-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 1/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-7006-4

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