scholarly journals Different progression pattern between acral and nonacral melanoma: A retrospective, comparative, clinicoprognostic study of 492 cases of primary cutaneous melanoma according to tumor site

2021 ◽  
Vol 0 ◽  
pp. 1-12
Author(s):  
Joon Min Jung ◽  
Chang Jin Jung ◽  
Chong Hyun Won ◽  
Sung Eun Chang ◽  
Mi Woo Lee ◽  
...  
Keyword(s):  
Lymph Node ◽  
Growth Phase ◽  
Medical Center ◽  
Lymph Node Involvement ◽  
Breslow Thickness ◽  
Primary Cutaneous Melanoma ◽  
Female Ratio ◽  
Acral Melanoma ◽  
Horizontal Diameter ◽  
The Difference

Background: There are limited data regarding the difference in progression pattern between acral melanoma and nonacral melanoma. Aims: The objectives of this study were to compare the progression pattern between acral and nonacral melanoma and evaluate its impact on clinical outcomes. Methods: Clinical and histopathological features, survival outcomes and prognostic factors of 492 patients with acral melanoma or nonacral melanoma were retrospectively evaluated using the Asan Medical Center database. Results: The male-to-female ratio and the mean age was 1:0.92 and 60.2 years for acral melanoma (n = 249), and 1:0.85 and 58.4 years for nonacral melanoma (n = 243), respectively. The demographic difference was not significant. Although prediagnosis duration was longer and the advanced stage was more common in acral melanoma than that in nonacral melanoma, the vertical growth phase was more common in nonacral melanoma than that in acral melanoma, whereas, the horizontal diameter is longer in acral melanoma than that in nonacral melanoma. Dissemination to lymph node was more common in acral melanoma than that in nonacral melanoma. Lymph node involvement was associated with deeper Breslow thickness in nonacral melanoma but not in acral melanoma. The degree of correlation of prediagnosis duration with horizontal diameter was remarkable in acral melanoma, but with Breslow thickness in nonacral melanoma. Overall survival was worse in acral melanoma than that in nonacral melanoma. The prognostic value of Breslow thickness was more remarkable in nonacral melanoma than that in acral melanoma. Limitations: This study is a retrospective, single-center design. Conclusion: Acral melanoma has a longer radial growth phase compared with nonacral melanoma. However, acral melanoma is commonly associated with lymph node dissemination which contributed to worse survival in acral melanoma than nonacral melanoma.

Tumor-Infiltrating Lymphocytes Predict Sentinel Lymph Node Positivity in Patients With Cutaneous Melanoma

2007 ◽  
Vol 25 (7) ◽  
pp. 869-875 ◽  
Author(s):  
Rebecca C. Taylor ◽  
Ami Patel ◽  
Katherine S. Panageas ◽  
Klaus J. Busam ◽  
Mary S. Brady
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Cutaneous Melanoma ◽  
Prognostic Significance ◽  
Tumor Infiltrating Lymphocytes ◽  
Breslow Thickness ◽  
Anatomic Site ◽  
Primary Cutaneous Melanoma ◽  
Male Sex ◽  
Infiltrating Lymphocytes

Purpose Tumor-infiltrating lymphocytes (TILs) are considered a manifestation of the host immune response to tumor, but the influence of TILs on outcome remains controversial. Studies evaluating the prognostic significance of TILs were published before routine examination of draining lymph nodes by sentinel lymph node (SLN) biopsy, the most important predictor of survival in patients with melanoma. The prognostic implications of TILs were re-evaluated in a large group of patients undergoing SLN biopsy at our institution. Patients and Methods All patients who underwent SLN mapping for primary cutaneous melanoma between January 1996 and July 2005 were evaluated. Univariate and multivariate analyses were performed to assess factors that predict SLN positivity and survival. Factors analyzed included Breslow thickness, ulceration, anatomic site, sex, Clark level, age, mitotic rate, and the presence (brisk or nonbrisk) or absence of TIL. Results Eight hundred eighty-seven patients underwent SLN mapping, and a SLN was identified in 875 patients (98.8%). The SLN was positive for tumor in 156 patients (17.6%). Multivariate analysis revealed that only Breslow thickness (P < .0001), ulceration (P = .0004), male sex (P = .03), and absent TILs (P = .0003) were independently predictive of the presence of SLN metastases. In melanomas with a brisk TIL infiltrate, the probability of a positive SLN was 3.9% as compared with 26.2% for melanomas in which TILs were absent. TILs were not an independent predictive factor for survival. Conclusion The absence of TILs, together with increasing Breslow thickness, presence of ulceration and male sex, predicts SLN metastasis in patients undergoing SLN biopsy for primary cutaneous melanoma.

scholarly journals Survival improvement and prognosis for hepatocellular carcinoma: analysis of the SEER database

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jingli Ding ◽  
Zhili Wen
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Lymph Node ◽  
The United States ◽  
Lymph Node Involvement ◽  
Seer Database ◽  
Old Patients ◽  
Female Ratio ◽  
Node Involvement ◽  
Over Time

Abstract Background Hepatocellular carcinoma (HCC) incidences have been increasing in the United States. This study aimed to examine temporal trend of HCC survival and determine prognostic factors influencing HCC survival within the U.S. population. Methods The Surveillance Epidemiology, and End Results (SEER) database was used to identify patients diagnosed with primary HCC from 1988 to 2015. Overall survival (OS) and disease-specific survival (DSS) were calculated by the Kaplan-Meier method. Univariate and multivariate Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for prognostic factors and comparing survival between patients diagnosed at different periods (per 5-year interval). Results A total of 80,347 patients were included. The proportions of both young patients (< 45 years) and old patients (≥75 years) decreased over time (P < 0.001) and the male-to-female ratio increased over time (P < 0.001). Significant decreasing temporal trends were observed for HCC severity at diagnosis, including SEER stage, tumor size, tumor extent, and lymph node involvement (P < 0.001 for all). OS and DSS of patients with HCC improved over time (P < 0.001). After adjusting for patient and tumor characteristics and treatment difference, period of diagnosis retained an independent factor for improved DSS and its prognostic significance was evident for localized and regional HCC (P < 0.001), but not for distant HCC. On multivariate analyses, young age, female gender, Hispanic ethnicity, and married status were predictors favoring DSS, whereas a worse DSS was observed for patients with tumor > 5 cm, with vascular invasion, and with lymph node involvement. Patients treated with liver-directed therapy (HR = 0.54, 95% CI: 0.35–0.56), hepatic resection (HR = 0.35, 95% CI: 0.33–0.37), and transplantation (HR = 0.14, 95% CI: 0.13–0.15) had significantly longer DSS compared with those who received no surgery. In stratified analyses, the beneficial effects of surgical approach, regardless therapy type, were significant across all stages. Conclusions Our results indicate a significant improvement in survival for HCC patients from 1988 to 2015, which may be attributable to advances in early diagnosis and therapeutic approaches.

scholarly journals Pelvic lymphadenectomy in vulvar cancer and its impact on prognosis and outcome

2021 ◽  
Author(s):  
A. Jaeger ◽  
K. Prieske ◽  
S. Mathey ◽  
I. Fischer ◽  
E. Vettorazzi ◽  
...  
Keyword(s):  
Lymph Node ◽  
Medical Center ◽  
Cell Cancer ◽  
Progression Free Survival ◽  
Figo Stage ◽  
Lymph Node Involvement ◽  
Pelvic Lymphadenectomy ◽  
Nodal Involvement ◽  
Node Positive ◽  
Node Involvement

Abstract Background The value of pelvic lymphadenectomy (LAE) has been subject of discussions since the 1980s. This is mainly due to the fact that the relation between lymph node involvement of the groin and pelvis is poorly understood and therewith the need for pelvic treatment in general. Patients and Methods N = 514 patients with primary vulvar squamous cell cancer (VSCC) FIGO stage ≥ IB were treated at the University Medical Center Hamburg-Eppendorf between 1996 and 2018. In this analysis, patients with pelvic LAE (n = 21) were analyzed with regard to prognosis and the relation of groin and pelvic lymph node involvement. Results The majority had T1b/T2 tumors (n = 15, 78.9%) with a median diameter of 40 mm (11–110 mm). 17/21 patients showed positive inguinal nodes. Pelvic nodal involvement without groin metastases was not observed. 6/17 node-positive patients with positive groin nodes also had pelvic nodal metastases (35.3%; median number of affected pelvic nodes 2.5 (1–8)). These 6 patients were highly node positive with median 4.5 (2–9) affected groin nodes. With regard to the metastatic spread between groins and pelvis, no contralateral spread was observed. Five recurrences were observed after a median follow-up of 33.5 months. No pelvic recurrences were observed in the pelvic nodal positive group. Patients with pelvic metastasis at first diagnosis had a median progression-free survival of only 9.9 months and overall-survival of 31.1 months. Conclusion A relevant risk for pelvic nodal involvement only seems to be present in highly node-positive disease, therefore pelvic staging (and radiotherapy) is probably unnecessary in the majority of patients with node-positive VSCC.

scholarly journals Correlation between pathological tumour stage and lymph node involvement in oral cancers: a descriptive study

2018 ◽  
Vol 6 (1) ◽  
pp. 257
Author(s):  
Deepak Paul ◽  
Moothedathparambil Ramakrishnan Babu ◽  
Krishnakumar Marar
Keyword(s):  
Lymph Node ◽  
Oral Cancer ◽  
Significant Positive Correlation ◽  
Descriptive Study ◽  
Tumor Stage ◽  
Lymph Node Involvement ◽  
Tumour Stage ◽  
Female Ratio ◽  
Positive Correlation ◽  
Node Involvement

Background: Involvement of cervical lymph nodes is the single most important prognostic factor in oral carcinoma. This study was aimed to evaluate the correlation between tumour stage and lymph node metastasis.Methods: A descriptive study was planned in oral cancer patients who fall within the inclusion criteria. This was compared with the postoperative histopathologic status of cervical nodes. Correlation analysis was done between tumor stage and lymph node metastasis.Results: Total 106 patients were included in the study. The male female ratio was 1.4:1. Majority of the patients 37(34.9%) were in the sixth decade of life. Carcinoma of the tongue was present in 17 cases while only 4 had carcinoma of lower alveolus. Most of the patients with oral cancer presented at an early stage (T1-T2). Stage IV was the commonest with 51 (48.1%) patients. Level I was the most commonly involved lymph node station (78.1%) in squamous cell carcinoma of oral cavity. A weak significant positive correlation between tumor stage and lymph node metastases (r =0.298) was found (p = 0.002). There was a moderate significant (p = 0.0001) positive correlation (r = 0.435) between pathological tumour stage and level of lymph node involvement. But the positive correlation was not statistically significant in carcinoma of the lower alveolus (r = 0.387, p=0.112).Conclusions: Significant positive correlation between pathological tumor stage and level of lymph node involvement in oral cancer and carcinoma tongue. But, in carcinoma lower alveolus the positive correlation was not significant.

Sentinel Lymphadenectomy in Cutaneous Melanoma

2002 ◽  
Vol 88 (3) ◽  
pp. S49-S51 ◽  
Author(s):  
O Buonomo ◽  
A Felici ◽  
AV Granai ◽  
R Piccirillo ◽  
N De Liguori Carino ◽  
...  
Keyword(s):  
Lymph Node ◽  
Cutaneous Melanoma ◽  
Drainage Basin ◽  
Lymph Node Involvement ◽  
Breslow Thickness ◽  
Blue Dye ◽  
Sentinel Lymphadenectomy ◽  
Vital Dye ◽  
Regional Lymphadenectomy ◽  
Positive Slns

Aims and Background In the last ten years validation of the sentinel lymph node (SLN) concept has led to modification of the surgical approach for patients with intermediate-risk cutaneous melanoma. Methods and Study Design Forty-eight patients affected by cutaneous melanoma with a Breslow thickness between 0.65 and 4 mm were enrolled in the study. Approximately 2 mCi of radiotracer and 1 mL of vital blue dye were injected in each patient around the site of the primary lesion. Lymphoscintigraphy was performed until the lymphatic basin and the respective SLN were localized. The whole surgical procedure consisted of enlargement of the surgical margins followed by localization and excision of the SLN(s) by using both radiotracer and vital dye. Whenever the SLN proved to be histologically positive for metastasis, complete regional lymphadenectomy was performed. Results Within 15 minutes of radiotracer administration the lymphatic basin was localized in all 48 patients by lymphoscintigraphy. Vital dye and radiotracer successfully allowed SLN localization and excision in 46 of 48 patients (97%); in one case the SLN was detected by radiotracer alone. The SLN proved to be metastatic in six (13%) of 46 evaluable patients; interestingly, in three of them the presence of metastatic cells was revealed only by immunohistochemistry. All patients with tumor-positive SLNs had primary lesions with a Breslow thickness = 2 mm. Conclusions Sentinel lymphadenectomy is able to identify lymph node involvement in patients with cutaneous melanoma with a Breslow thickness >1 mm, thus avoiding the risks associated with radical regional lymphadenectomy. Lymphoscintigraphy proved to be an important tool to obtain correct preoperative localization of the drainage basin, especially for melanomas located on the face and trunk.

scholarly journals Can initial grade of endometrial cancer presenting at Tata Medical Center, predict high risk factors which will require lymph node dissection and adjuvant therapy?

2016 ◽  
Author(s):  
Basumita Chakraborti ◽  
Anik Ghosh ◽  
Jaydip Bhaumik ◽  
Asima Mukhopadhyay
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Adjuvant Therapy ◽  
Medical Center ◽  
Myometrial Invasion ◽  
Lymph Node Involvement ◽  
Pelvic Lymph Node ◽  
Node Dissection ◽  
Node Involvement ◽  
Pelvic Lymph Node Involvement

Background: Pre-operative tumor grade influences the type of surgery planned for endometrial cancer, while the final grade affects the adjuvant therapy. Aims and Objectives: To predict whether pre surgery tumour grade can predict tlymph node dissection and adjuvant therapy in endometriod endometrial cancer. Methods: Retrospective observational study. Data was obtained from electronic hospital medical records system. All women with a diagnosis of endometrioid endometrial cancer who attended TMC, Kolkata between September 2011 and June 2015 included. Review of the histology was asked in all patients and MDT was planned for all patients. Most of the patients operated in TMC underwent standard pre-operative imaging work up like MRI pelvis and CT upper abdomen and chest evaluation. Staging/completion surgery included total hysterectomy, BSO, pelvic +/- para aortic lymphadenectomy +/- Omental biopsy. The surgico-pathological evaluation included histology, grade, myometrial invasion, adnexal involvement and nodal involvement. Results: 155 patients had both initial and final histology. Of total 67 patients with initial grade 1 histology, 8 (12%) were upgraded to G2 and 1 (1.5%) was upgraded to G3. 35 patients with G2 disease 2 (5.7%) were upgraded to G3. Among 8 patients with G3, 7 continued to be G3. Of the 67 patients with initial grade 1, > 50% invasion was seen in 25 (37.3%). Of 35 patients with initial G2, > 50% myometrial invasion was seen in 13 (37.1%) patients. Among 8 initial G3 patients, > 50% invasion was seen in 3 (37.5%) patients. Of these 67 patients with grade 1, pelvic lymph nodes were involved in 4 (6%) patients. None of the grade 2 tumors had pelvic lymph node involvement. One (12.5%) out of 8 patients with initial G3 tumor had pelvic lymph node involvement. Recurrence was seen in 3/67 (4.5%) of G1 patients, 7/35 (20%) with G2 cases and 1/8 (12.5%) with G3 cases. Conclusion: Patients with initial G1 disease, about 13% were upgraded. Recurrence rate increased with G2 patients. For all initial grade tumors the mymetrial involvement > 50% was 37%. For initial G1 patients the pelvic lymph node involvement was found to be 6%. For G3 tumor the pelvic lymph node involvement was 12.5%.

scholarly journals Analysis of primary oral and oropharyngeal squamous cell carcinoma in Beijing inhabitants, China—a 10-year continuous study of a single center

2020 ◽  
Author(s):  
Xuexiao Bai ◽  
Jie Zhang ◽  
Li Wei
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Lymph Node Involvement ◽  
Oropharyngeal Squamous Cell Carcinoma ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Node Involvement

Abstract Backgroud The aim of the study was to evaluate whether Beijing inhabitants with oral and oropharyngeal squamous cell carcinoma(OSCC) differ from previous reports with regard to clinicopathological characteristics and prognosis, and study the influence of prognostic factors. Methods Consecutive cases of primary oral and oropharyngeal squamous cell carcinoma in Beijing patients admitted between 2004 and 2013 were analyzed retrospectively. Clinical data included age, sex, location, site, TNM stage, history of drinking and smoking, differentiation and follow up information. Results A total of 603 cases were included in this study. The male: female ratio was 1.1:1. The frequency of sites decreased in the order tongue, gingiva, buccal mucosa, oral floor, oropharynx, lip and palate. Differences in location, age and stage between males and females were statistically significant (P < 0.05). Whereas 65.3% of male patients smoked or drank, only 6.3% of female patients did so. The overall 5-year survival rate was 64%. Female patients have a worse prognosis than male. For patients who received surgery, tumor size, lymph node involvement were independent prognostic factors. Smoking and drinking were not prognostic factors. Conclusion Our study indicates that the clinical characteristics OSCC patients in Beijing is similar to some developed countries, both regarding male/female ratio, diagnostic age, prognosis, which is different from previous reports in other districts of China. Lymph node involvement was the most important prognostic factor, followed by tumor size, pathological grade.

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