Prognostic markers in lentigo maligna patients treated with imiquimod cream: A long-term follow-up study

J Am Acad Dermatol. 2016 Jan;74(1):81-87.e1. doi: 10.1016/j.jaad.2015.08.031. Epub 2015 Oct 23.

Abstract

Background: More data are needed to define factors that predict long-term success after imiquimod therapy for lentigo maligna (LM).

Objective: We sought to determine the demographic, clinical, and histologic prognostic markers of relapse-free survival in patients with LM who were treated with imiquimod.

Methods: This was a single-arm, open-label, nonrandomized, prospective study.

Results: Eighty-nine patients with histologically confirmed LM and a median follow-up time of 4.8 years after imiquimod treatment were included in our study. Sixteen patients (18%) relapsed. Statistically significant indicators of an increased risk of local recurrence included: the total number of melanocytes, the number of basal and suprabasal melanocytes and the number of pagetoid spreading melanocytes.

Limitations: Our study was a single-center, nonrandomized study.

Conclusion: An assessment of different melanocyte fractions in the diagnostic baseline biopsy specimen may help to predict the response of LM to imiquimod therapy.

Keywords: efficacy; follow-up; imiquimod; lentigo maligna; prognostic marker; recurrence; topical immunomodulators.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Administration, Cutaneous
  • Adult
  • Aged
  • Aged, 80 and over
  • Aminoquinolines / administration & dosage*
  • Antineoplastic Agents / administration & dosage
  • Biomarkers, Tumor / analysis
  • Biopsy, Needle
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Hutchinson's Melanotic Freckle / drug therapy*
  • Hutchinson's Melanotic Freckle / mortality
  • Hutchinson's Melanotic Freckle / pathology*
  • Imiquimod
  • Immunohistochemistry
  • Male
  • Melanocytes / pathology
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Staging
  • Prospective Studies
  • Risk Assessment
  • Skin Cream / administration & dosage
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / mortality
  • Skin Neoplasms / pathology*
  • Switzerland
  • Time Factors
  • Treatment Outcome

Substances

  • Aminoquinolines
  • Antineoplastic Agents
  • Biomarkers, Tumor
  • Imiquimod