Статья

Tumor-Infiltrating Lymphocyte Grade Is an Independent Predictor of Sentinel Lymph Node Status and Survival in Patients With Cutaneous Melanoma

Farhad AzimiFarhad Azimi, Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Melanoma Institute Australia; Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Sydney Medical School, The University of Sydney; Pavlina Rumcheva, School of Public Health, The University of Sydney, Sydney; Richard A. Scolyer, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Royal Prince AlfredRichard A. ScolyerFarhad Azimi, Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Melanoma Institute Australia; Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Sydney Medical School, The University of Sydney; Pavlina Rumcheva, School of Public Health, The University of Sydney, Sydney; Richard A. Scolyer, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Royal Prince AlfredPavlina RumchevaFarhad Azimi, Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Melanoma Institute Australia; Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Sydney Medical School, The University of Sydney; Pavlina Rumcheva, School of Public Health, The University of Sydney, Sydney; Richard A. Scolyer, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Royal Prince AlfredMarc MoncrieffFarhad Azimi, Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Melanoma Institute Australia; Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Sydney Medical School, The University of Sydney; Pavlina Rumcheva, School of Public Health, The University of Sydney, Sydney; Richard A. Scolyer, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Royal Prince AlfredRajmohan MuraliFarhad Azimi, Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Melanoma Institute Australia; Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Sydney Medical School, The University of Sydney; Pavlina Rumcheva, School of Public Health, The University of Sydney, Sydney; Richard A. Scolyer, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Royal Prince AlfredStanley W. McCarthyFarhad Azimi, Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Melanoma Institute Australia; Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Sydney Medical School, The University of Sydney; Pavlina Rumcheva, School of Public Health, The University of Sydney, Sydney; Richard A. Scolyer, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Royal Prince AlfredRobyn P.M. SawFarhad Azimi, Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Melanoma Institute Australia; Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Sydney Medical School, The University of Sydney; Pavlina Rumcheva, School of Public Health, The University of Sydney, Sydney; Richard A. Scolyer, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Royal Prince AlfredJohn F. ThompsonFarhad Azimi, Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Melanoma Institute Australia; Richard A. Scolyer, Marc Moncrieff, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Sydney Medical School, The University of Sydney; Pavlina Rumcheva, School of Public Health, The University of Sydney, Sydney; Richard A. Scolyer, Rajmohan Murali, Stanley W. McCarthy, Robyn P. Saw, and John F. Thompson, Royal Prince Alfred

2012en

ABI

Аннотация

PURPOSE: To determine whether density and distribution of tumor-infiltrating lymphocytes (TILs; TIL grade) is an independent predictor of sentinel lymph node (SLN) status and survival in patients with clinically localized primary cutaneous melanoma. METHODS: From the Melanoma Institute Australia database, 1,865 patients with a single primary melanoma ≥ 0.75 mm in thickness were identified. The associations of clinical and pathologic factors with SLN status, recurrence-free survival (RFS), and melanoma-specific survival (MSS) were analyzed. RESULTS: The majority of patients had either no (TIL grade 0; 35.4%) or few (TIL grade 1; 45.1%) TILs, with a minority showing moderate (TIL grade 2; 16.3%) or marked (TIL grade 3; 3.2%) TILs. Tumor thickness, mitotic rate, and Clark level were inversely correlated with TIL grade (each P < .001). SLN biopsy was performed in 1,138 patients (61.0%) and was positive in 252 (22.1%). There was a significant inverse association between SLN status and TIL grade (SLN positivity rates for each TIL grade: 0, 27.8%; 1, 20.1%; 2, 18.3%; 3, 5.6%; P < .001). Predictors of SLN positivity were decreasing age (P < .001), decreasing TIL grade (P < .001), ulceration (P = .003), increasing tumor thickness (P = .01), satellitosis (P = .03), and increasing mitoses (P = .03). The 5-year MSS and RFS rates were 83% and 76%, respectively (median follow-up, 43 months). Tumor thickness (P < .001), ulceration (P < .001), satellitosis (P < .001), mitotic rate (P = .003), TIL grade (P < .001), and sex (P = .01) were independent predictors of MSS. Patients with TIL grade 3 tumors had 100% survival. CONCLUSION: TIL grade is an independent predictor of survival and SLN status in patients with melanoma. Patients with a pronounced TIL infiltrate have an excellent prognosis.

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Идентификаторы

DOI: 10.1200/jco.2011.37.8539

Цитирования и источники

Цитирований: 2Использованных источников: 0

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