Sentinel node tumor burden in prediction of prognosis in melanoma patients
| Autor: | Juha Jernman, Leea Ylitalo, Niina Korhonen, Johanna Palve, Tiina Luukkaala |
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| Přispěvatelé: | Lääketieteen ja terveysteknologian tiedekunta - Faculty of Medicine and Health Technology, Yhteiskuntatieteiden tiedekunta - Faculty of Social Sciences, Tampere University, HUS Inflammation Center, Clinicum, Department of Dermatology, Allergology and Venereology |
| Rok vydání: | 2020 |
| Předmět: |
Male
Oncology Cancer Research Skin Neoplasms CUTANEOUS MELANOMA MULTICENTER 0302 clinical medicine Surgical oncology 030212 general & internal medicine DISSECTION Melanoma Lymph node Hematology General Medicine Middle Aged Sentinel node Prognosis POSITIVE MELANOMA Tumor Burden 3. Good health Dissection medicine.anatomical_structure Chemotherapy Adjuvant Lymphatic Metastasis 030220 oncology & carcinogenesis BIOPSY Female Sentinel Lymph Node Sentinel node-positive Research Paper medicine.medical_specialty 3122 Cancers Risk Assessment 03 medical and health sciences Syöpätaudit - Cancers Internal medicine Prognosis in melanoma medicine Adjuvant therapy Humans TRUNK Aged Proportional Hazards Models Retrospective Studies Sentinel node tumor burden Sentinel Lymph Node Biopsy business.industry Retrospective cohort study medicine.disease Lymph Node Excision business Follow-Up Studies |
| Zdroj: | Clinical & Experimental Metastasis |
| ISSN: | 1573-7276 0262-0898 |
| Popis: | Recent data have demonstrated no survival benefit to immediate completion lymph node dissection (CLND) for positive sentinel node (SN) disease in melanoma. It is important to identify parameters in positive SNs, which predict prognosis in melanoma patients. These might provide prognostic value in staging systems and risk models by guiding high-risk patients’ adjuvant therapy in clinical practice. In this retrospective study of university hospital melanoma database we analyzed tumor burden and prognosis in patients with positive SNs. Patients were stratified by the diameter of tumor deposit, distribution of metastatic focus in SN, ulceration and number of metastatic SNs. These were incorporated in Cox proportional hazard regression models. Predictive ability was assessed using Akaike information criterion and Harrell’s concordance index. A total of 110 patients had positive SN and 104 underwent CLND. Twenty-two (21%) patients had non-SN metastatic disease on CLND. The 5-year melanoma specific survival for CLND-negative patients was 5.00 years (IQR 3.23–5.00, range 0.72–5.00) compared to 3.69 (IQR 2.28–4.72, range 1.01–5.00) years in CLND-positive patients (HR 2.82 (95% CI 1.17–6.76, p = 0.020).The models incorporating distribution of metastatic focus and the largest tumor deposit in SN had highest predictive ability. According to Cox proportional hazard regression models, information criterions and c-index, the diameter of tumor deposit > 4 mm with multifocal location in SN despite of number of metastatic SN were the most important parameters. According to the diameter of tumor deposit and distribution of metastatic focus in SN, adequate stratification of positive SN patients was possible and risk classes for patients were identified. |
| Databáze: | OpenAIRE |
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