Lymphovascular invasion as a prognostic factor in melanoma
| Autor: | Michael E, Egger, Julianna E, Gilbert, Alison L, Burton, Kelly M, McMasters, Glenda G, Callender, Amy R, Quillo, Russell E, Brown, Charles R, St Hill, Lee, Hagendoorn, Robert C G, Martin, Arnold J, Stromberg, Charles R, Scoggins |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Aged 80 and over Male Analysis of Variance Skin Neoplasms Sentinel Lymph Node Biopsy Kaplan-Meier Estimate Middle Aged Prognosis Risk Assessment Survival Analysis Disease-Free Survival Young Adult Predictive Value of Tests Cause of Death Lymphatic Metastasis Multivariate Analysis Humans Female Neoplasm Invasiveness Lymph Nodes Prospective Studies Melanoma Aged Proportional Hazards Models |
| Zdroj: | The American surgeon. 77(8) |
| ISSN: | 1555-9823 |
| Popis: | The prognostic significance of lymphovascular invasion (LVI) in melanoma remains controversial. Clinicopathologic data from a prospective trial of patients with melanoma were analyzed with respect to LVI. Disease-free survival and overall survival (OS) were evaluated by Kaplan-Meier (KM) analysis. Univariate and multivariate analyses were performed to evaluate factors predictive of tumor-positive sentinel nodes (SLN) and survival. A total of 2183 patients were included in this analysis; 171 (7.8%) had LVI. Median follow-up was 68 months. Factors associated with LVI included tumor thickness, ulceration, and histologic subtype (P0.05). LVI was associated with a greater risk of SLN metastasis (P0.05). By KM analysis, LVI was associated with worse OS (P = 0.0009). On multivariate analysis, age, gender, thickness, ulceration, anatomic location, and SLN status were predictors of OS; however, LVI was not an independent predictor of OS. Among patients with regression, the 5-year OS rate was 49.4 per cent for patients with LVI versus 81.1 per cent for those with no LVI (P0.0001). LVI is associated with a greater risk of SLN metastasis. Although LVI is not an independent predictor of OS in general, it is a powerful predictor of worse OS among patients who have evidence of regression of the primary tumor. |
| Databáze: | OpenAIRE |
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