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Histological immune response patterns in sentinel lymph nodes involved by metastatic melanoma and prognostic significance
Author(s) -
Abbott James,
Buckley Meghan,
Taylor Laura A.,
Xu George,
Karakousis Giorgos,
Czerniecki Brian J.,
Gimotty Phyllis A.,
Zhang Paul J.
Publication year - 2018
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/cup.13127
Subject(s) - medicine , germinal center , lymph , melanoma , lymph node , pathology , sentinel lymph node , cohort , oncology , cancer , immunology , b cell , cancer research , breast cancer , antibody
Background To further characterize the micromorphometric immunological pattern to metastatic melanoma in sentinel lymph node (SLN) biopsies and completion lymph node (CLN) dissections and their relation to 5‐year overall survival (OS). Methods Retrospective cohort of 49 patients from 1996 to 2005 with a positive SLN who underwent CLN dissection (CLD) was studied. Micromorphometric characteristics included follicular center count (FCC)/profile, sinus histiocytosis, metastatic size, tumor infiltrating lymphocytes (intranodal), paracortical dendritic cells, germinal center reaction and morphology. Comparison of Kaplan‐Meier survival curves used the exact log‐rank statistic. Results In the high‐FCC ( n = 5‐51) vs the low‐FCC ( n < 5) lymph nodes, a delayed separation occurred at 3 years, with 5‐year OS rates being 73% vs 54% in the high‐ and low‐FCC groups, respectively. Improved survival up to 3 years was also noted in CLDs that showed a higher FCC when compared to the prior SLN. Patients with metastatic deposits >2 mm had significantly lower 5‐year survival (both <.001). Conclusions Nodal micromorphometric features (ie, FCC) are probably related to host immune response to metastasis. Quantitative evaluation of lymphoid follicular centers could provide valuable prognostic information to help to stratify patients.