Main Article Content
melanoma, prognosis, histopathology
Recommended guidelines for sentinel lymph node biopsy, follow-up, and surveillance for cutaneous melanoma are based upon clinicopathologic staging. In effect, the accuracy of melanoma staging to estimate metastatic risk is critical to subsequent care, neither under-treating or over-treating the patient based on their tumor. Traditional staging continues to evolve based on additional data regarding clinicopathologic features and clinical outcomes. However, such features are subject to inter-observer variability, which puts a limit on their ability to improve prognostication. Reported discordance rates between initial and subsequent pathology review consistently impact both staging and disease management. Newer molecular techniques, such as gene expression profiling, can be used to help define the biology of the primary melanoma tumor and the best course of action after definitive surgical treatment.
2. Santillan AA, Messina JL, Marzban SS, Crespo G, Sondak VK, Zager JS. Pathology review of thin melanoma and melanoma in situ in a multidisciplinary melanoma clinic: impact on treatment decisions. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2010;28(3):481-486.
3. Dandekar M, Lowe L, Fullen DR, et al. Discordance in histopathologic evaluation of melanoma sentinel lymph node biopsy with clinical follow-up: results from a prospectively collected database. Annals of surgical oncology. 2014;21(11):3406-3411.
4. Monshizadeh L, Hanikeri M, Beer TW, Heenan PJ. A critical review of melanoma pathology reports for patients referred to the Western Australian Melanoma Advisory Service. Pathology. 2012;44(5):441-447.
5. Murali R, Hughes MT, Fitzgerald P, Thompson JF, Scolyer RA. Interobserver variation in the histopathologic reporting of key prognostic parameters, particularly clark level, affects pathologic staging of primary cutaneous melanoma. Annals of surgery. 2009;249(4):641-647.
6. Niebling MG, Haydu LE, Karim RZ, Thompson JF, Scolyer RA. Pathology review significantly affects diagnosis and treatment of melanoma patients: an analysis of 5011 patients treated at a melanoma treatment center. Annals of surgical oncology. 2014;21(7):2245-2251.
7. Gastman BR, Gerami P, Kurley SJ, Cook RW, Leachman S, Vetto JT. Identification of patients at risk for metastasis using a prognostic 31-gene expression profile in subpopulations of melanoma patients with favorable outcomes by standard criteria. Journal of the American Academy of Dermatology. 2018;In press.
8. Hsueh EC, DeBloom JR, Lee J, et al. Interim analysis of survival in a prospective, multi-center registry cohort of cutaneous melanoma tested with a prognostic 31-gene expression profile test. Journal of hematology & oncology. 2017;10(1):152.
9. Greenhaw BN, Zitelli JA, Brodland DG. Estimation of Prognosis in Invasive Cutaneous Melanoma: An Independent Study of the Accuracy of a Gene Expression Profile Test. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al]. 2018.
10. Cook RW, Middlebrook B, Wilkinson J, et al. Analytic validity of DecisionDx-Melanoma, a gene expression profile test for determining metastatic risk in melanoma patients. Diagnostic pathology. 2018;13(1):13.
11. Dillon LD, Gadzia JE, Davidson RS, et al. Prospective, Multicenter Clinical Impact Evaluation of a 31-Gene Expression Profile Test for Management of Melanoma Patients. SKIN, The Journal of Cutaneous Medicine. 2018;2(3):111-121.
12. Schuitevoerder D, Heath M, Cook RW, et al. Impact of Gene Expression Profiling on Decision-Making in Clinically Node Negative Melanoma Patients after Surgical Staging. Journal of drugs in dermatology : JDD. 2018;17(2):196-199.