Absence of Tumor-Infiltrating Lymphocyte Is a Reproducible Predictive Factor for Sentinel Lymph Node Metastasis: A Multicenter Database Study by the Brazilian Melanoma Group

• Published in: PloS one 2016-02, Vol.11 (2), p.e0148160-e0148160
• Main Authors: Duprat, João Pedreira, Brechtbülh, Eduard René, Costa de Sá, Bianca, Enokihara, Mauro, Fregnani, Jose Humberto, Landman, Gilles, Maia, Marcus, Riccardi, Felice, Belfort, Francisco Alberto, Wainstein, Alberto, Moredo, Luciana F, Steck, Higino, Brandão, Miguel, Moreno, Marcelo, Miranda, Eduardo, Santos, Ivan Dunshee de Oliveira
• Format: Article
• Language: English
• Subjects: Biology and Life Sciences; Biopsy; Brazil; Cancer; Cancer metastasis; Cell Count; Confidence intervals; Databases, Factual; Female; Hospitals; Humans; Immunotherapy; Lymph; Lymph nodes; Lymphatic Metastasis; Lymphatic system; Lymphocytes; Lymphocytes, Tumor-Infiltrating - cytology; Male; Medical prognosis; Medical records; Medical schools; Medicine and Health Sciences; Melanoma; Melanoma - diagnosis; Melanoma - immunology; Melanoma - pathology; Metastases; Metastasis; Middle Aged; Mitosis; Patients; Prognosis; Quality of life; Retrospective Studies; Risk analysis; Risk factors; Studies; Tumor-infiltrating lymphocytes
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0148160

The aim of this study is to confirm the function of tumor-infiltrating lymphocytes (TILs) in sentinel lymph node (SLN) metastasis. This retrospective study included 633 patients with invasive melanoma who underwent sentinel lymph node biopsy in 7 referral centers certified by the Brazilian Melanoma Group. Independent risk factors of sentinel node metastasis (SNL) were identified by multiple logistic regression. SLN metastasis was detected in 101 of 633 cases (16.1%) and in 93 of 428 patients (21.7%) when melanomas ≤ 1mm were excluded. By multiple logistic regression, the absence of TILs was as an independent risk factor of SLN metastasis (OR = 1.8; 95%CI: 1.1-3.0), in addition to Breslow index (greater than 2.00 mm), lymph vascular invasion, and presence of mitosis. SLNB can identify patients who might benefit from immunotherapy, and the determination of predictors of SLNB positivity can help select the proper population for this type of therapy. The absence of TILs is a reproducible parameter that can predict SLNB positivity in melanoma patients, since this study was made with several centers with different dermatopathologists.