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Prognostic Significance of Molecular Staging Study of Sentinel Lymph Nodes by Reverse Transcriptase-Polymerase Chain Reaction for Tyrosinase in Melanoma Patients

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Abstract

Background

We performed this study to evaluate the clinical effect of microscopic and submicroscopic metastases in sentinel lymph nodes (SLNs) from patients with early-stage melanoma.

Methods

Patients with confirmed cutaneous melanoma (American Joint Committee on Cancer stages I and II) underwent standard lymphoscintigraphy and SLN biopsy. Serial sections were divided between routine histopathology with hematoxylin and eosin plus immunohistochemistry for HMB-45 and molecular analysis by nested reverse transcriptase-polymerase chain reaction (RT-PCR) assay for tyrosinase (using β-actin as a control).

Results

Of 180 patients analyzed (318 SLNs), 38 (21%) patients had positive SLN(s) by routine hematoxylin and eosin and immunohistochemistry (microscopic disease; group 1), and 142 (79%) had negative histological results. Analysis by RT-PCR detected tyrosinase in at least 1 SLN from 124 (69%) patients. Among patients with histologically negative SLN(s), tyrosinase was detected in 86 (48%) patients (submicroscopic disease; group 2), whereas 40 (22%) patients had negative results by both histology and RT-PCR (group 3). Sixteen (9%) patients had histologically negative SLNs and ambiguous RT-PCR results (group 4). Among 138 patients in the analysis of recurrence (mean follow-up, 45 months), only 18 patients had a recurrence: 11 (31%) of 35 in group 1, 5 (10%) of 51 in group 2, and 2 (5%) of 37 in group 3. No recurrences were seen in group 4. Only group 1 had a significantly shorter disease-free survival and overall survival compared with the other groups.

Conclusions

After a long follow-up period, molecular upstaging by tyrosinase RT-PCR failed to detect a subgroup of patients with an increased probability of recurrence.

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Acknowledgments

Supported by grants from Fondo de Investigaciones Sanitarias (98/0449 and 02/933) and the Red Española de Centros de Genómica del Cáncer (C03/10).

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Authors and Affiliations

  1. Department of Dermatology, Hospital Universitario Germans Trias i Pujol, Carretera Canyet s/n., 08916, Badalona, Spain

    Cristina Mangas MD, Josep M. Hilari BS, Cristina Paradelo MD, Jordi Rex MD & Carlos Ferrándiz MD, PhD

  2. Department of Pathology, Hospital Universitario Germans Trias i Pujol, Universidad Autónoma de Barcelona, Carretera Canyet s/n., 08916, Badalona, Spain

    Maria Teresa Fernández-Figueras MD, PhD

  3. Department of Nuclear Medicine, Hospital Universitario Germans Trias i Pujol, Universidad Autónoma de Barcelona, Carretera Canyet s/n., 08916, Badalona, Spain

    Manel Fraile MD, PhD

  4. Department of Surgery, Hospital Universitario Germans Trias i Pujol, Universidad Autónoma de Barcelona, Carretera Canyet s/n., 08916, Badalona, Spain

    Antoni Alastrue MD

Authors
  1. Cristina Mangas MD
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  2. Josep M. Hilari BS
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  3. Cristina Paradelo MD
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  4. Jordi Rex MD
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  5. Maria Teresa Fernández-Figueras MD, PhD
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  6. Manel Fraile MD, PhD
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  7. Antoni Alastrue MD
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  8. Carlos Ferrándiz MD, PhD
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Corresponding author

Correspondence to Carlos Ferrándiz MD, PhD.

Additional information

C. Mangas and J. M. Hilari contributed equally to this work.

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Mangas, C., Hilari, J.M., Paradelo, C. et al. Prognostic Significance of Molecular Staging Study of Sentinel Lymph Nodes by Reverse Transcriptase-Polymerase Chain Reaction for Tyrosinase in Melanoma Patients. Ann Surg Oncol 13, 910–918 (2006). https://doi.org/10.1245/ASO.2006.12.010

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  • DOI: https://doi.org/10.1245/ASO.2006.12.010

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