Desmoplastic melanoma: The role of pure and mixed subtype in sentinel lymph node biopsy and survival

Abstract Background Desmoplastic melanoma (DM) is an uncommon type of melanoma. Two histological subtypes of DM can be distinguished: pure and mixed (PDM and MDM). We hypothesized that discrimination between these subtypes is associated with sentinel lymph node biopsy (SLNB) status and survival. Met...

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Main Authors: Annelien E. Laeijendecker, Mary‐Ann El Sharouni, Vigfús Sigurdsson, Paul J. vanDiest
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.2736
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author Annelien E. Laeijendecker
Mary‐Ann El Sharouni
Vigfús Sigurdsson
Paul J. vanDiest
author_facet Annelien E. Laeijendecker
Mary‐Ann El Sharouni
Vigfús Sigurdsson
Paul J. vanDiest
author_sort Annelien E. Laeijendecker
collection DOAJ
description Abstract Background Desmoplastic melanoma (DM) is an uncommon type of melanoma. Two histological subtypes of DM can be distinguished: pure and mixed (PDM and MDM). We hypothesized that discrimination between these subtypes is associated with sentinel lymph node biopsy (SLNB) status and survival. Methods Clinicopathological data from PALGA, the Dutch Pathology Register were retrieved from patients diagnosed with DM in The Netherlands between 2000 and 2014. Clinical and pathological variables were extracted from pathology text files, including pure or mixed desmoplastic morphology. A Cox proportional hazard model was performed for overall and recurrence‐free survival (OS and RFS). Results A total of 239 patients with DM were included, representing 0.4% of all primary cutaneous melanoma in The Netherlands. A total of 114 PDM and 125 MDM patients were identified. MDM was significantly associated with positive SLNB status (P = .035). In multivariable analysis, age (HR 1.10, 95% CI 1.07‐1.14, P < .001) and ulceration (HR 1.98, 95% CI 1.05‐3.75, P = .036) were significant predictors for OS. For RFS, mixed subtype (HR 2.72 95% CI 1.07‐6.89, P = .035), male gender (HR 2.54, 95% CI 1.03‐6.27, P = .043), and Breslow thickness (HR 1.13 per mm, 95% CI 1.05‐1.21, P = .001) were significant predictors. Conclusion MDM is significantly associated with a positive SLNB status. Mixed subtype is significantly correlated with RFS, but not with OS. The distinction between pure and mixed desmoplastic subtype therefore seems to be of clinical importance.
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spelling doaj-art-b74694f6a5df44a2b67da50b41f43f0e2025-08-25T10:14:05ZengWileyCancer Medicine2045-76342020-01-019267167710.1002/cam4.2736Desmoplastic melanoma: The role of pure and mixed subtype in sentinel lymph node biopsy and survivalAnnelien E. Laeijendecker0Mary‐Ann El Sharouni1Vigfús Sigurdsson2Paul J. vanDiest3Department of Dermatology University Medical Centre Utrecht Utrecht University Utrecht The NetherlandsDepartment of Dermatology University Medical Centre Utrecht Utrecht University Utrecht The NetherlandsDepartment of Dermatology University Medical Centre Utrecht Utrecht University Utrecht The NetherlandsDepartment of Pathology University Medical Centre Utrecht Utrecht University Utrecht The NetherlandsAbstract Background Desmoplastic melanoma (DM) is an uncommon type of melanoma. Two histological subtypes of DM can be distinguished: pure and mixed (PDM and MDM). We hypothesized that discrimination between these subtypes is associated with sentinel lymph node biopsy (SLNB) status and survival. Methods Clinicopathological data from PALGA, the Dutch Pathology Register were retrieved from patients diagnosed with DM in The Netherlands between 2000 and 2014. Clinical and pathological variables were extracted from pathology text files, including pure or mixed desmoplastic morphology. A Cox proportional hazard model was performed for overall and recurrence‐free survival (OS and RFS). Results A total of 239 patients with DM were included, representing 0.4% of all primary cutaneous melanoma in The Netherlands. A total of 114 PDM and 125 MDM patients were identified. MDM was significantly associated with positive SLNB status (P = .035). In multivariable analysis, age (HR 1.10, 95% CI 1.07‐1.14, P < .001) and ulceration (HR 1.98, 95% CI 1.05‐3.75, P = .036) were significant predictors for OS. For RFS, mixed subtype (HR 2.72 95% CI 1.07‐6.89, P = .035), male gender (HR 2.54, 95% CI 1.03‐6.27, P = .043), and Breslow thickness (HR 1.13 per mm, 95% CI 1.05‐1.21, P = .001) were significant predictors. Conclusion MDM is significantly associated with a positive SLNB status. Mixed subtype is significantly correlated with RFS, but not with OS. The distinction between pure and mixed desmoplastic subtype therefore seems to be of clinical importance.https://doi.org/10.1002/cam4.2736desmoplasticmelanomasentinel nodesurvival
spellingShingle Annelien E. Laeijendecker
Mary‐Ann El Sharouni
Vigfús Sigurdsson
Paul J. vanDiest
Desmoplastic melanoma: The role of pure and mixed subtype in sentinel lymph node biopsy and survival
Cancer Medicine
desmoplastic
melanoma
sentinel node
survival
title Desmoplastic melanoma: The role of pure and mixed subtype in sentinel lymph node biopsy and survival
title_full Desmoplastic melanoma: The role of pure and mixed subtype in sentinel lymph node biopsy and survival
title_fullStr Desmoplastic melanoma: The role of pure and mixed subtype in sentinel lymph node biopsy and survival
title_full_unstemmed Desmoplastic melanoma: The role of pure and mixed subtype in sentinel lymph node biopsy and survival
title_short Desmoplastic melanoma: The role of pure and mixed subtype in sentinel lymph node biopsy and survival
title_sort desmoplastic melanoma the role of pure and mixed subtype in sentinel lymph node biopsy and survival
topic desmoplastic
melanoma
sentinel node
survival
url https://doi.org/10.1002/cam4.2736
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AT vigfussigurdsson desmoplasticmelanomatheroleofpureandmixedsubtypeinsentinellymphnodebiopsyandsurvival
AT pauljvandiest desmoplasticmelanomatheroleofpureandmixedsubtypeinsentinellymphnodebiopsyandsurvival