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http://purl.uniprot.org/citations/21135695http://www.w3.org/1999/02/22-rdf-syntax-ns#typehttp://purl.uniprot.org/core/Journal_Citation
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Objective

To determine the long-term clinical significance of molecular upstaging in histopathology-negative, paraffin-embedded (PE) sentinel lymph nodes (SLNs) from melanoma patients.

Background

Histopathologic evaluation can miss clinically relevant melanoma micrometastases in SLNs. This longitudinal correlative study is the first 10-year prognostic evaluation of a multimarker quantitative real-time reverse transcriptase-polymerase chain reaction (qRT) assay for PE melanoma-draining SLNs.

Methods

The SLN sections (n = 214) were assessed by qRT assay for 4 established messenger RNA biomarkers: MART-1, MAGE-A3, GalNAc-T, and PAX3.

Results

The qRT assay upstaged 48 of 161 histopathology-negative (hematoxylin-eosin and immunohistochemistry) SLN specimens. At a median follow-up of 11.3 years for the entire cohort, estimated rates of 10-year overall survival (OS) and melanoma-specific survival (MSS) were 82% and 94%, respectively, for histopathology-negative/qRT-negative patients; 56% and 61%, respectively, for histopathology-positive patients; and 52% and 60%, respectively, for histopathology-negative/qRT-positive patients (P < 0.001 for OS, P < 0.001 for MSS). In a multivariate analysis of known melanoma prognostic factors, qRT positivity was significant (P < 0.05) for disease-free survival (hazard ratio [HR], 4.3; 95% confidence interval (CI), 2.3-7.8), distant disease-free survival (HR, 6.6; 95% CI, 2.9-14.6), MSS (HR, 6.2; 95% CI, 2.6-14.4), and OS (HR, 2.8; 95% CI, 1.6-4.9).

Conclusion

The multimarker qRT assay has prognostic significance for molecular upstaging of PE melanoma-draining SLNs. Molecular upstaging of histopathology-negative SLNs confers a prognosis similar to that associated with SLN micrometastasis, and the number of positive qRT biomarkers is correlated to disease outcome."xsd:string
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http://purl.uniprot.org/citations/21135695http://purl.uniprot.org/core/author"Takeuchi H."xsd:string
http://purl.uniprot.org/citations/21135695http://purl.uniprot.org/core/author"Elashoff D."xsd:string
http://purl.uniprot.org/citations/21135695http://purl.uniprot.org/core/author"Hoon D.S."xsd:string
http://purl.uniprot.org/citations/21135695http://purl.uniprot.org/core/author"Morton D.L."xsd:string
http://purl.uniprot.org/citations/21135695http://purl.uniprot.org/core/author"Nicholl M.B."xsd:string
http://purl.uniprot.org/citations/21135695http://purl.uniprot.org/core/date"2011"xsd:gYear
http://purl.uniprot.org/citations/21135695http://purl.uniprot.org/core/name"Ann Surg"xsd:string
http://purl.uniprot.org/citations/21135695http://purl.uniprot.org/core/pages"116-122"xsd:string
http://purl.uniprot.org/citations/21135695http://purl.uniprot.org/core/title"Molecular upstaging based on paraffin-embedded sentinel lymph nodes: ten-year follow-up confirms prognostic utility in melanoma patients."xsd:string
http://purl.uniprot.org/citations/21135695http://purl.uniprot.org/core/volume"253"xsd:string
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