Validation of a clinicopathological and gene expression profile model for sentinel lymph node metastasis in primary cutaneous melanoma.
Validation of a clinicopathological and gene expression profile model for sentinel lymph node metastasis in primary cutaneous melanoma.
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DOI：
10.1111/bjd.19499
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
Hollestein LM
中科院分区：
文献类型：
--
作者：
Mulder EEAP;Dwarkasing JT;Tempel D;van der Spek A;Bosman L;Verver D;Mooyaart AL;van der Veldt AAM;Verhoef C;Nijsten TEC;Grunhagen DJ;Hollestein LM
The Clinicopathological and Gene Expression Profile (CP‐GEP) model was developed to accurately identify patients with T1–T3 primary cutaneous melanoma at low risk for nodal metastasis. To validate the CP‐GEP model in an independent Dutch cohort of patients with melanoma. Patients (aged ≥ 18 years) with primary cutaneous melanoma who underwent sentinel lymph node biopsy (SLNB) between 2007 and 2017 at the Erasmus Medical Centre Cancer Institute were eligible. The CP‐GEP model combines clinicopathological features (age and Breslow thickness) with the expression of eight target genes involved in melanoma metastasis (ITGB3, PLAT, SERPINE2, GDF15, TGFBR1, LOXL4, CXCL8 and MLANA). Using the pathology result of SLNB as the gold standard, performance measures of the CP‐GEP model were calculated, resulting in CP‐GEP high risk or low risk for nodal metastasis. In total, 210 patients were included in the study. Most patients presented with T2 (n = 94, 45%) or T3 (n = 70, 33%) melanoma. Of all patients, 27% (n = 56) had a positive SLNB, with nodal metastasis in 0%, 30%, 54% and 16% of patients with T1, T2, T3 and T4 melanoma, respectively. Overall, the CP‐GEP model had a negative predictive value (NPV) of 90·5% [95% confidence interval (CI) 77·9–96.2], with an NPV of 100% (95% CI 72·2–100) in T1, 89·3% (95% CI 72·8–96·3) in T2 and 75·0% (95% CI 30·1–95·4) in T3 melanomas. The CP‐GEP indicated high risk in all T4 melanomas. The CP‐GEP model is a noninvasive and validated tool that accurately identified patients with primary cutaneous melanoma at low risk for nodal metastasis. In this validation cohort, the CP‐GEP model has shown the potential to reduce SLNB procedures in patients with melanoma. The majority (70–85%) of patients with cutaneous melanoma who undergo a sentinel lymph node biopsy (SLNB) procedure have no metastasis in the SLN. To identify patients at low risk for nodal metastasis, the Clinicopathological and Gene Expression Profile (CP‐GEP) model was developed (n = 754 patients, US cohort). The CP‐GEP model combines age, Breslow thickness and the expression of eight target genes involved in melanoma metastasis, and has the potential to reduce SLNB procedures in patients with T1–T3 cutaneous melanoma. What is already known about this topic? This is the first independent validation of the CP‐GEP model in European patients with primary cutaneous melanoma. The CP‐GEP model can be applied to full‐excision tumour tissue and does not require macrodissection of tumour tissue. The CP‐GEP model has a negative predictive value of 90·5% (95% confidence interval 77·9–96·2) in T1–T3 melanomas. The CP‐GEP model is a promising tool in patient care. In this validation cohort, the CP‐GEP model has shown the potential to reduce SLNB procedures in patients with primary cutaneous melanoma. What does this study add?
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DOI：
10.1056/nejmoa1613210
发表时间：
2017-06-08
期刊：
The New England journal of medicine
影响因子：
--
作者：
Faries MB;Thompson JF;Cochran AJ;Andtbacka RH;Mozzillo N;Zager JS;Jahkola T;Bowles TL;Testori A;Beitsch PD;Hoekstra HJ;Moncrieff M;Ingvar C;Wouters MWJM;Sabel MS;Levine EA;Agnese D;Henderson M;Dummer R;Rossi CR;Neves RI;Trocha SD;Wright F;Byrd DR;Matter M;Hsueh E;MacKenzie-Ross A;Johnson DB;Terheyden P;Berger AC;Huston TL;Wayne JD;Smithers BM;Neuman HB;Schneebaum S;Gershenwald JE;Ariyan CE;Desai DC;Jacobs L;McMasters KM;Gesierich A;Hersey P;Bines SD;Kane JM;Barth RJ;McKinnon G;Farma JM;Schultz E;Vidal-Sicart S;Hoefer RA;Lewis JM;Scheri R;Kelley MC;Nieweg OE;Noyes RD;Hoon DSB;Wang HJ;Elashoff DA;Elashoff RM
通讯作者：
Elashoff RM
影响因子：
8.4
作者：
Garbe, Claus;Peris, Ketty;Eggermont, Alexander M.
通讯作者：
Eggermont, Alexander M.
影响因子：
158.5
作者：
Long, G. V.;Hauschild, A.;Kirkwood, J. M.
通讯作者：
Kirkwood, J. M.
影响因子：
45.3
作者：
Bilimoria, Karl Y.;Balch, Charles M.;Lange, Julie R.
通讯作者：
Lange, Julie R.
影响因子：
45.3
作者：
Balch, Charles M.;Gershenwald, Jeffrey E.;Sondak, Vernon K.
通讯作者：
Sondak, Vernon K.