Details

Autor(en) / Beteiligte

• Boada, Aram
• Tejera‐Vaquerizo, Antonio
• Ribero, Simone
• Puig, Susana
• Moreno‐Ramírez, David
• Descalzo‐Gallego, Miguel A.
• Fierro, María T.
• Quaglino, Pietro
• Carrera, Cristina
• Malvehy, Josep
• Vidal‐Sicart, Sergi
• Bennássar, Antoni
• Rull, Ramón
• Alos, Llucìa
• Requena, Celia
• Bolumar, Isidro
• Traves, Víctor
• Pla, Ángel
• Fernández‐Figueras, María T.
• Ferrándiz, Carlos
• Pascual, Iciar
• Manzano, José L.
• Sánchez‐Lucas, Marina
• Giménez‐Xavier, Pol
• Ferrandiz, Lara
• Nagore, Eduardo

Titel

Sentinel lymph node biopsy versus observation in thick melanoma: A multicenter propensity score matching study

Ist Teil von

• International journal of cancer, 2018-02, Vol.142 (3), p.641-648

Ort / Verlag

United States: Wiley Subscription Services, Inc

Erscheinungsjahr

2018

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• The clinical value of sentinel lymph node (SLN) biopsy in thick melanoma patients (Breslow >4 mm) has not been sufficiently studied. The aim of the study is to evaluate whether SLN biopsy increases survival in patients with thick cutaneous melanoma, and, as a secondary objective, to investigate correlations between survival and lymph node status. We included 1,211 consecutive patients with thick melanomas (>4 mm) registered in the participating hospitals' melanoma databases between 1997 and 2015. Median follow‐up was 40 months. Of these patients, 752 were matched into pairs by propensity scores based on sex, age, tumor location, histologic features of melanoma, year of diagnosis, hospital and adjuvant interferon therapy. The SLN biopsy vs. observation was associated with better DFS [adjusted hazard ratio (AHR), 0.74; 95% confidence interval (CI) 0.61–0.90); p = 0.002] and OS (AHR, 0.75; 95% CI, 0.60–0.94; p = 0.013) but not MSS (AHR, 0.84; 95% CI, 0.65–1.08; p = 0.165). SLN‐negative patients had better 5‐ and 10‐year MSS compared with SLN‐positive patients (65.4 vs. 51.9% and 48.3 vs. 38.8%; p = 0.01, respectively). As a conclusion, SLN biopsy was associated with better DFS but not MSS in thick melanoma patients after adjustment for classic prognostic factors. SLN biopsy is useful for stratifying these patients into different prognostic groups. What's new? Sentinel lymph node biopsy, which helps identify whether melanoma has begun metastasizing, has chiefly been studied in medium thickness melanomas. How useful is it in melanomas more than 4 mm thick? Here, the authors show that performing a SLN biopsy improves disease‐free survival (DFS), but not melanoma‐specific survival. Those patients with a positive SLN had worse DFS than patients whose sentinel nodes were clear of cancer. Thus, they conclude, the SLN biopsy is essential for stratifying patients by risk, but not as a therapeutic tool against thick melanoma.