Tags

Type your tag names separated by a space and hit enter

Challenges in sentinel node pathology in the era of adjuvant treatment.
J Surg Oncol. 2020 Jun 29 [Online ahead of print]JS

Abstract

BACKGROUND

With the approval of adjuvant therapy for stage III melanoma, accurate staging is more important than ever. Sentinel node biopsy (SNB) is an accurate staging tool, yet the presence of capsular nevi (CN) can lead to a false-positive diagnosis.

PATIENTS AND METHODS

Retrospective analysis of the American Joint Committee on Cancer 7th edition stage IIIA melanoma patients who were treated at our institute between 2000 and 2015. SNB slides were reviewed for this study by an expert melanoma pathologist.

RESULTS

Of 159 eligible patients, 14 originally diagnosed with metastatic melanoma merely had CN (8.8%). Another two merely had melanophages (1.3%). Thus, 10.1% of SNs were considered false positive after revision. In 12 patients, the SN tumor burden was originally reported as larger than 1 mm but turned out to be less than 1 mm. Four patients originally reported as SN tumor burden less than 1 mm before revision turned out to have larger than 1 mm. These patients might have been over- or undertreated in the current era of adjuvant therapy for stage III melanoma.

CONCLUSIONS

Distinguishing metastatic melanoma from benign CN and melanophages can be a diagnostic challenge. We plead for an expert pathologists' review, especially when using the SNB + results to determine treatment consequences.

Authors+Show Affiliations

Departments of Surgical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.Departments of Surgical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.Division of Pathology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.Department of Head and Neck Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.Departments of Surgical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.Departments of Surgical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.Division of Pathology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.Departments of Surgical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32602119

Citation

Franke, Viola, et al. "Challenges in Sentinel Node Pathology in the Era of Adjuvant Treatment." Journal of Surgical Oncology, 2020.
Franke V, Madu MF, Bierman C, et al. Challenges in sentinel node pathology in the era of adjuvant treatment. J Surg Oncol. 2020.
Franke, V., Madu, M. F., Bierman, C., Klop, W. M. C., van Houdt, W. J., Wouters, M. W. J. M., van de Wiel, B. A., & van Akkooi, A. C. J. (2020). Challenges in sentinel node pathology in the era of adjuvant treatment. Journal of Surgical Oncology. https://doi.org/10.1002/jso.26095
Franke V, et al. Challenges in Sentinel Node Pathology in the Era of Adjuvant Treatment. J Surg Oncol. 2020 Jun 29; PubMed PMID: 32602119.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Challenges in sentinel node pathology in the era of adjuvant treatment. AU - Franke,Viola, AU - Madu,Max F, AU - Bierman,Carolien, AU - Klop,Willem M C, AU - van Houdt,Winan J, AU - Wouters,Michel W J M, AU - van de Wiel,Bart A, AU - van Akkooi,Alexander C J, Y1 - 2020/06/29/ PY - 2019/09/21/received PY - 2020/05/24/revised PY - 2020/06/18/accepted PY - 2020/7/1/entrez KW - BRAF KW - adjuvant therapy KW - capsular nevi KW - capsule nevus KW - completion lymph node dissection KW - immunotherapy KW - melanoma KW - sentinel node JF - Journal of surgical oncology JO - J Surg Oncol N2 - BACKGROUND: With the approval of adjuvant therapy for stage III melanoma, accurate staging is more important than ever. Sentinel node biopsy (SNB) is an accurate staging tool, yet the presence of capsular nevi (CN) can lead to a false-positive diagnosis. PATIENTS AND METHODS: Retrospective analysis of the American Joint Committee on Cancer 7th edition stage IIIA melanoma patients who were treated at our institute between 2000 and 2015. SNB slides were reviewed for this study by an expert melanoma pathologist. RESULTS: Of 159 eligible patients, 14 originally diagnosed with metastatic melanoma merely had CN (8.8%). Another two merely had melanophages (1.3%). Thus, 10.1% of SNs were considered false positive after revision. In 12 patients, the SN tumor burden was originally reported as larger than 1 mm but turned out to be less than 1 mm. Four patients originally reported as SN tumor burden less than 1 mm before revision turned out to have larger than 1 mm. These patients might have been over- or undertreated in the current era of adjuvant therapy for stage III melanoma. CONCLUSIONS: Distinguishing metastatic melanoma from benign CN and melanophages can be a diagnostic challenge. We plead for an expert pathologists' review, especially when using the SNB + results to determine treatment consequences. SN - 1096-9098 UR - https://www.unboundmedicine.com/medline/citation/32602119/Challenges_in_sentinel_node_pathology_in_the_era_of_adjuvant_treatment L2 - https://doi.org/10.1002/jso.26095 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.