Sentinel lymph node biopsy versus observation in thick melanoma: A multicenter propensity score matching study
| Autor: | Isidro Bolumar, David Moreno-Ramírez, Celia Requena, Cristina Carrera, Jose Luis Manzano, Maria Teresa Fierro, Eduardo Nagore, M.A. Descalzo-Gallego, Maria T. Fernández-Figueras, Susana Puig, Josep Malvehy, Lara Ferrándiz, Victor Traves, Marina Sánchez-Lucas, Ángel Pla, Iciar Pascual, Pol Gimenez-Xavier, Sergi Vidal-Sicart, Simone Ribero, Llucia Alos, Antoni Bennàssar, Aram Boada, Antonio Tejera-Vaquerizo, Ramón Rull, Carlos Ferrándiz, Pietro Quaglino |
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| Rok vydání: | 2017 |
| Předmět: |
Cancer Research
medicine.medical_specialty medicine.diagnostic_test business.industry Melanoma Sentinel lymph node Hazard ratio medicine.disease Gastroenterology Confidence interval Surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Internal medicine Cutaneous melanoma Propensity score matching Biopsy medicine 030212 general & internal medicine business Lymph node |
| Zdroj: | International Journal of Cancer. 142:641-648 |
| ISSN: | 0020-7136 |
| DOI: | 10.1002/ijc.31078 |
| Popis: | 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 1211 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 = .002) and OS (AHR, 0.75; 95% CI, 0.60-0.94; P = .013) but not MSS (AHR, 0.84; 95% CI, 0.65-1.08; P = .165). SLN-negative patients had better 5- and 10-year MSS compared to 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. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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