Mitosis en melanoma

Journal Scan / Research · November 14, 2019

The Prognostic Value of Tumor Mitotic Rate in Children and Adolescents With Cutaneous Melanoma

Journal of the American Academy of Dermatology

TAKE-HOME MESSAGE

• Mitosis (≥1/mm2) was seen in 104 of 156 patients (67%) aged < 20 years with clinically localized cutaneous melanoma, and it correlated with increasing Breslow thickness. With a median follow-up of 61 months, 5-year melanoma-specific and recurrence-free survival rates were 91% and 84%, respectively. Mitotic rate was a stronger predictor of survival outcome than Breslow thickness, and the only independent predictor of recurrence-free survival. 

• In children and adolescents with localized cutaneous melanoma, mitotic rate may be an important predictor of survival and aid in prognostic stratification and treatment planning.

– InYoung Kim, MD PhD

Abstract 

BACKGROUND

Mitotic rate is a strong predictor of outcome in adult patients with primary cutaneous melanoma but for children and adolescent patients this is unknown.

OBJECTIVE

To assess the prognostic value of primary tumor mitotic rate in children and adolescents with primary melanoma.

METHODS

Cohort study of 156 patients aged < 20 years with clinically-localized cutaneous melanoma. Patients <12 years were classified as children and those 12-19 years as adolescents. Clinicopathological and outcome data were collected. Recurrence-free and melanoma-specific survival were calculated. Univariable and multivariable analyses were performed using Cox proportional hazard models.

RESULTS

Thirteen of the 156 patients (8%) were children. Mitotic rate was ≥1/mm2 in 104 patients (67%) and correlated with increasing Breslow thickness. A positive sentinel node was found in 23 of the 61 patients (38%) who underwent sentinel node biopsy. Median follow-up was 61 months. Five-year melanoma-specific and recurrence-free survival were 91% and 84%, respectively. Mitotic rate was a stronger predictor of outcome than tumor thickness, and the only factor independently associated with recurrence-free survival.

LIMITATIONS

single institution, small sample size CONCLUSION: Mitotic rate is an independent predictor of recurrence-free survival in children and adolescents with clinically localized melanoma.

Journal of the American Academy of Dermatology

The Prognostic Value of Tumor Mitotic Rate in Children and Adolescents With Cutaneous Melanoma: A Retrospective Cohort Study

J Am Acad Dermatol 2019 Nov 01;[EPub Ahead of Print], NA Ipenburg, SN Lo, RE Vilain, LHJ Holtkamp, JS Wilmott, OE Nieweg, JF Thompson, RA Scolyer 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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