Assessment of tumor mitotic rate in primary cutaneous malignant melanomas 1 mm or less in thickness

Background Tumor mitotic rate in thin melanomas is recognized as a powerful, independent prognostic factor predicting survival. In nonulcerated cases, the presence of any dermal mitotic activity upstages the disease to pT1b. The extent to which tissue should be histologically examined to assess mito...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2015-03, Vol.72 (3), p.405-409
Main Authors: Shin, Christina, MBChB, Tallon, Ben, MBChB, FRACP
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Dermatology
Female
hot spot method
Humans
Male
malignant melanoma
Melanoma - metabolism
Melanoma - pathology
Melanoma, Cutaneous Malignant
Middle Aged
Mitosis
prognostic factor
Retrospective Studies
Skin Neoplasms
thin melanoma
tissue sections
Tumor Burden
tumor mitotic rate
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Summary:Background Tumor mitotic rate in thin melanomas is recognized as a powerful, independent prognostic factor predicting survival. In nonulcerated cases, the presence of any dermal mitotic activity upstages the disease to pT1b. The extent to which tissue should be histologically examined to assess mitogenicity, however, has not been studied. Objective We sought to determine whether in staging thin melanomas, there is a significant benefit in examining numerous tissue sections containing invasive disease. Method In all, 71 cases of thin cutaneous melanomas diagnosed between January 2012 and June 2013 were identified after a search performed on the Pathlab database. The slides were retrieved and reviewed retrospectively, comparing the identification of the first dermal tumor mitotic figure, if present, at 4 check-points: the first, third, fifth, or tenth tissue section examined. Results A statistically significant difference in identification of the first dermal mitotic figure was found in examining 1 versus 3 tissue sections ( P  = .0411). No significant difference was found in examining numerous tissue sections. Limitations This was a retrospective study from a single institution with a limited number of participants. Conclusion In staging thin melanomas without ulceration, the optimal number of sections to assess is 3. No additional benefit is gained by examining numerous tissue sections.
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2014.09.057