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Sex-Specific Prognostic Implications in Melanoma

J Am Acad Dermatol; ePub 2018 Mar 5; Sinnamon, et al

The implications of tumor-infiltrating lymphocytes (TILs) in predicting sentinel lymph node (SLN) positivity appear to be more relevant for men than women, a recent study found. Patients with clinically localized primary melanoma ≥0.76mm in Breslow thickness who underwent SLN biopsy were identified. Association between TILs (absent, nonbrisk, and brisk) and SLN positivity was evaluated using logistic regression. Overall survival (OS) was evaluated by TILs status and sex. Among 1,367 patients identified, 794 were men. Researchers found:

  • TILs were brisk in 143 lesions, nonbrisk in 903, and absent in 321, which did not vary by sex.
  • SLN positivity was associated with TILs among men (brisk 3.8%, nonbrisk 16.9%, absent 26.6%).
  • In contrast, there was no association between SLN positivity and TILs among women.
  • Interaction between brisk TILs and sex on SLN positivity was significant.
  • Among men, presence of brisk TILs was associated with prolonged OS but not after adjustment for SLN status.
  • There was no association between TILs status and OS among women.

Sinnamon AJ, Sharon CE, Song Y, et al. The prognostic significance of tumor-infiltrating lymphocytes for primary melanoma varies by sex. [Published online ahead of print March 5, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.02.066.

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