Sentinel lymph node biopsy in patients with clinical stage IIB/C cutaneous melanoma: A national cohort study - 16/09/22
, Cimarron E. Sharon, MD a, Emily Y. Chu, MD, PhD b, John T. Miura, MD a, Michael E. Ming, MD, MSCE b, Giorgos C. Karakousis, MD aAbstract |
Background |
Approval of adjuvant anti-programmed cell death protein 1 therapy for pathologic stage IIB/C cutaneous melanoma has led some to question the role of sentinel lymph node (SLN) biopsy in the clinical stage IIB/C disease.
Objective |
To determine the prognostic significance of SLN staging on disease-specific survival (DSS) for clinical stage IIB/C primary cutaneous melanoma in the preimmunotherapy era.
Methods |
A retrospective cohort study was performed evaluating patients who underwent excision of clinical stage IIB/C cutaneous melanoma using the Surveillance, Epidemiology, and End Results database (2004-2011). Patients who did and did not undergo SLN biopsy were compared using propensity matching, and among those who underwent SLN biopsy, matched patients were further stratified by SLN status (SLN positive [SLN+] or SLN negative [SLN-]).
Results |
Of the 8562 patients evaluated, 6021 (70.3%) underwent SLN biopsy. SLN positivity was associated with significantly reduced 5-year DSS among matched patients who underwent SLN biopsy (47.1% SLN+ vs 75.5% SLN-; P < .001). Five-year DSS remained significantly different across matched T-stages: T3b (54.2% SLN+ vs 64.8% SLN-; P = .004), T4a (55.5% SLN+ vs 71.6% SLN-; P = .001), and T4b (38.6% SLN+ vs 60.9% SLN-; P < .001).
Limitations |
Retrospective study.
Conclusion |
For patients with clinical stage IIB/C cutaneous melanoma, SLN status provides essential prognostic information.
Le texte complet de cet article est disponible en PDF.Key words : adjuvant therapy, immunotherapy, melanoma, prognosis, sentinel node, sentinel lymph node biopsy, survival
Abbreviations used : APC, DSS, IQR, OR, SEER, SLN, SLN+, SLN-
Plan
| Senior authors Ming and Karakousis contributed equally to this article. |
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| Funding sources: None. |
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| This study has been accepted for a concurrent mini-symposium presentation at the 2022 Society for Investigative Dermatology Annual Meeting, scheduled for May 18-21, 2022, in Portland, Oregon. |
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| IRB approval status: Exempt. |
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| Reprints not available from the authors. |
Vol 87 - N° 4
P. 754-760 - octobre 2022 Retour au numéro
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