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The prognostic significance of microsatellites in cutaneous melanoma.
Modern Pathology ( IF 7.1 ) Pub Date : 2020-02-13 , DOI: 10.1038/s41379-020-0500-9 Maarten G Niebling 1 , Lauren E Haydu 1, 2, 3 , Serigne N Lo 1 , Robert V Rawson 1, 4, 5 , Lieke G E Lamboo 1 , Joram T Stollman 1 , Rooshdiya Z Karim 1, 4, 5 , John F Thompson 1, 2, 6 , Richard A Scolyer 1, 4, 5
Modern Pathology ( IF 7.1 ) Pub Date : 2020-02-13 , DOI: 10.1038/s41379-020-0500-9 Maarten G Niebling 1 , Lauren E Haydu 1, 2, 3 , Serigne N Lo 1 , Robert V Rawson 1, 4, 5 , Lieke G E Lamboo 1 , Joram T Stollman 1 , Rooshdiya Z Karim 1, 4, 5 , John F Thompson 1, 2, 6 , Richard A Scolyer 1, 4, 5
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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.
中文翻译：
微卫星在皮肤黑色素瘤中的预后意义。
显微卫星转移是原发性皮肤黑色素瘤患者的不良预后特征。使用第八版美国癌症联合委员会的定义，微卫星的预后意义，包括其数量、大小和与原发性黑色素瘤的距离，此前尚未进行过评估。本研究旨在确定微卫星在组织病理学病例中的预后意义。对原始病理报告和所有可用的组织病理学幻灯片中记录的 87 例存在微卫星的原发性皮肤黑色素瘤病例进行了审查，并将结果与临床结果相关。为所有确诊的微卫星病例选择匹配的对照病例。 69 个病例中证实存在微卫星。微卫星组的预后明显较差，5 年无病生存率为 21%，而对照组为 56%（p < 0.001）。微卫星组的 5 年黑色素瘤特异性生存率为 53%，对照组为 73%（p = 0.004）。研究发现，增加微卫星与原发性黑色素瘤的距离（毫米）会对无病生存率（HR = 1.24，95% CI：1.13-1.36，p < 0.001）和总生存率（HR = 1.26 95% CI：1.13）产生不利影响。 -1.40，p < 0.001）和黑色素瘤特异性生存率（HR = 1.27 95% CI：1.11-1.45，p < 0.001）。微卫星的数量和大小不是显着的预后因素。在多变量分析中，微卫星的存在是被证明是前哨淋巴结阳性独立预测因素的唯一因素（OR 4.64；95% CI 1.66-12.95；p = 0.003）。微卫星与更多的局部区域复发显着相关（p < 0.001），但与远处转移无关（p = 0.821）。 因此，根据第八版美国癌症联合委员会分期系统的定义，具有微卫星的黑色素瘤是侵袭性肿瘤，与显着较差的无病生存率、总生存率和黑色素瘤特异性生存率相关。微卫星的存在也与前哨淋巴结阳性以及局部和途中复发有关。微卫星与原发肿瘤的距离增加是一个独立的不良预后因素，值得进一步评估。
更新日期：2020-02-13
中文翻译：
微卫星在皮肤黑色素瘤中的预后意义。
显微卫星转移是原发性皮肤黑色素瘤患者的不良预后特征。使用第八版美国癌症联合委员会的定义，微卫星的预后意义，包括其数量、大小和与原发性黑色素瘤的距离，此前尚未进行过评估。本研究旨在确定微卫星在组织病理学病例中的预后意义。对原始病理报告和所有可用的组织病理学幻灯片中记录的 87 例存在微卫星的原发性皮肤黑色素瘤病例进行了审查，并将结果与临床结果相关。为所有确诊的微卫星病例选择匹配的对照病例。 69 个病例中证实存在微卫星。微卫星组的预后明显较差，5 年无病生存率为 21%，而对照组为 56%（p < 0.001）。微卫星组的 5 年黑色素瘤特异性生存率为 53%，对照组为 73%（p = 0.004）。研究发现，增加微卫星与原发性黑色素瘤的距离（毫米）会对无病生存率（HR = 1.24，95% CI：1.13-1.36，p < 0.001）和总生存率（HR = 1.26 95% CI：1.13）产生不利影响。 -1.40，p < 0.001）和黑色素瘤特异性生存率（HR = 1.27 95% CI：1.11-1.45，p < 0.001）。微卫星的数量和大小不是显着的预后因素。在多变量分析中，微卫星的存在是被证明是前哨淋巴结阳性独立预测因素的唯一因素（OR 4.64；95% CI 1.66-12.95；p = 0.003）。微卫星与更多的局部区域复发显着相关（p < 0.001），但与远处转移无关（p = 0.821）。 因此，根据第八版美国癌症联合委员会分期系统的定义，具有微卫星的黑色素瘤是侵袭性肿瘤，与显着较差的无病生存率、总生存率和黑色素瘤特异性生存率相关。微卫星的存在也与前哨淋巴结阳性以及局部和途中复发有关。微卫星与原发肿瘤的距离增加是一个独立的不良预后因素，值得进一步评估。
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