PLoS ONE (Jan 2016)

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

  • João Pedreira Duprat,
  • Eduard René Brechtbülh,
  • Bianca Costa de Sá,
  • Mauro Enokihara,
  • Jose Humberto Fregnani,
  • Gilles Landman,
  • Marcus Maia,
  • Felice Riccardi,
  • Francisco Alberto Belfort,
  • Alberto Wainstein,
  • Luciana F Moredo,
  • Higino Steck,
  • Miguel Brandão,
  • Marcelo Moreno,
  • Eduardo Miranda,
  • Ivan Dunshee de Oliveira Santos

DOI
https://doi.org/10.1371/journal.pone.0148160
Journal volume & issue
Vol. 11, no. 2
p. e0148160

Abstract

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AIMS:The aim of this study is to confirm the function of tumor-infiltrating lymphocytes (TILs) in sentinel lymph node (SLN) metastasis. MATERIALS AND METHODS: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. RESULTS: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. CONCLUSION: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.