Lymphangioinvasion in routine H&E staining is strongly associated with poor clinical outcome in lymph node-negative cutaneous melanoma patients

Abstract

Introduction. Lymphatic invasion (LYI) and lymphangiogenesis in the primary tumor are important processes related to the dissemination of neoplasms. The aim of the study was to examine the relationship of LYI status in cutaneous melanoma with patient survival and clinicopathological data.

Material and methods. LYI status was assessed in 104 hematoxylin-eosin (H&E) stained melanoma primary tumor samples and analyzed in relation to patient survival and other clinicopathological and histopathological characteristics.

Results. LYI was found in 30 (28.8%) patients. It was observed more frequently in ulcerated, proliferating, and thicker tumors. It correlated with the presence of sentinel lymph node, regional and distant metastases. The presence of LYI significantly correlated with shorter overall survival, cancer specific overall survival and disease-free survival in Kaplan-Meier analysis (all P < 0.001). Positive LYI status was a factor of unfavorable prognosis also in patients without regional lymph node metastases.

Conclusions. Our results support earlier observations that LYI is a powerful prognostic factor. We recommend an assessment of LYI status during routine review of cutaneous melanoma slides stained with H&E as a standard, potentially informative, yet economically beneficial procedure.